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Effect of Left Ventricular Outflow Tract Obstruction on Clinical Outcome in Hypertrophic Cardiomyopathy
Ist Teil von
The New England journal of medicine, 2003-01, Vol.348 (4), p.295-303
Ort / Verlag
Boston, MA: Massachusetts Medical Society
Erscheinungsjahr
2003
Quelle
Free E-Journal (出版社公開部分のみ)
Beschreibungen/Notizen
The effect of obstructed left ventricular outflow due to a hypertrophied interventricular septum is controversial. In this large study of patients with hypertrophic cardiomyopathy, an outflow gradient of at least 30 mm Hg at rest predicted an increased risk of progression to severe heart failure or death from cardiovascular causes.
Hypertrophic cardiomyopathy is a genetic cardiac disease with heterogeneous phenotypic expression and a diverse clinical course characterized by both sudden death and disabling symptoms related to heart failure.
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Historically, even from the first clinical descriptions, the left ventricular outflow tract gradient has been a prominent and quantifiable feature of hypertrophic cardiomyopathy.
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Major therapeutic interventions (such as ventricular septal myectomy, percutaneous alcohol septal ablation, and dual-chamber pacing) have been introduced to relieve disabling symptoms associated with outflow tract obstruction.
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However, the long-term effect of the subaortic gradient on clinical outcome continues to be a . . .