Effects of postural changes on left atrial function in patients with hypertrophic cardiomyopathy☆,☆☆,★,★★
Section snippets
Study population
The study cohort consisted of 27 patients with typical echocardiographic Doppler findings8 of hypertrophic obstructive cardiomyopathy (HOCM). Inclusion criteria were (1) a hypertrophic nondilated left ventricle (ventricular septum thickness ≥13 mm), (2) a basal interventricular pressure gradient of 30 mm Hg recorded in the left ventricular outflow tract, (3) normal coronary arteries at angiography, and (4) no underlying cardiac or systemic disease.
A group of 17 patients with HCM were also
Baseline characterstics and echocardiographic data
There were no differences between the study groups with respect to age, sex, and body mass index (Table I). Left ventricular ejection fraction was significantly higher in patients with HOCM compared with normal subjects (P < .005). Normal subjects had a significantly thinner interventricular septum and a lower ventricular septum/posterior wall ratio (P < .001). Furthermore, normal subjects had a significantly increased left ventricular end-systolic volume index compared with patients with HOCM
Discussion
In this study, we estimated left atrial contribution to left ventricular filling by means of mitral flow velocity measured with Doppler echocardiography in normal subjects, patients with HOCM, and patients with HCM. Moreover, we examined the effects of postural changes on left atrial function in these patients. Similar studies have been reported,13, 14, 15 but the postural changes were not examined in these groups of patients. We assessed left atrial function by using Doppler echocardiography,
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Cited by (18)
LV twisting and untwisting in HCM: Ejection begets filling: Diastolic functional aspects of HCM
2011, American Heart JournalCitation Excerpt :This is influenced by diastolic duration, venous return,7,8 the interplay of active myocardial relaxation and passive diastolic properties,3,9-12 by systolic torsion release and diastolic recoil,13-18 by external constraints including the pericardium and pleural pressures,7,8,19,20 coronary flow and vascular turgor (“erectile effect”),21-25 and atrial contraction. Since at end-diastole the atrium is ordinarily about one third the LV size, atrial contraction can contribute 15% to 35% of LV end-diastolic blood volume, depending on heart rate and other applying conditions.26-31 Diastolic function and its interacting determinants are systematically explored in previous reviews.3,9,15,32-40
Effects of levosimendan on restrictive left ventricular filling in severe heart failure: A combined hemodynamic and Doppler echocardiographic study
2005, ChestCitation Excerpt :All independent variables selected were added to a single regression model in order to explore the association between hemodynamic parameters and left ventricular diastolic function indexes. In the stepwise selection method, the equation starts as “empty,” and independent variables are added one at a time provided the statistical criteria for entry (stepping method criteria: F probability for entry, 0.05; F probability for removal, 0.1) are met.15,16 Analysis was performed using statistical software (SPSS Regression with Collinearity Diagnostics option, with SPSS Explore for evaluation of regression assumptions; SPSS; Chicago, IL).
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From the Department of Cardiology, Hippokration Hospital, University of Athens.
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Supported by a grant from the Hellenic Heart Foundation.
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Reprint requests: John Dernellis, MD, 61 Kousidou St, 15772 Zografou, Athens, Greece.
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