Zezulka et al have described that propranolol can reduce LVOT
gradients in cases of HC, thereby reducing red cell shear stress (3).
In the present study, our results demonstrated that ADM (15 mg/kg) treatment significantly reduced the EF, FS, and peak Vel of LVOT
and increased the LV mass compared with controls; co-treatment with Rg3 and ADM effectively prevented ADM-induced cardiac dysfunction.
Figures 4 and 5 depict apical 3- and 5-chamber views showing turbulence across the LVOT
beginning below the aortic valve (in the baffle between VSD and aorta).
CO was obtained using the Doppler method and was calculated from SV x HR, where SV is the product of LVOT
CSA and LVOT
TTE in apical four-chamber color-Doppler imaging demonstrating shows the accessory papillary muscle across the LVOT
Although the exact incidence of catecholamine induced LVOT
obstruction after mitral valve repair has not yet been reported, these effects could be worsened when anatomical abnormalities, such as degenerative changes on the anterior cusp of the mitral valve and basal septal hypertrophy, are combined (2).
Another aspect of Concha's study was their use of LVOT
area together with aortic blood flow, instead of LVOT
blood flow, to calculate the CO.
The most common clinical presentation is symptomatic left ventricular outflow tract (LVOT
) obstruction occurring as a result of mass effect in the early years of life or progressing gradually due to the continued accumulation of fibrous tissue within the LVOT
and generally becomes symptomatic as dyspnea on exertion, chest pain, syncope or very rarely cerebrovascular accident.
No gradient was detected between LVOT
and aorta by catheterization.
Historically the next intervention that was applied to reduce LVOT
obstruction was DDD pacing with atrioventricular (AV) delay (57-59).
Pre and post-operative transesophageal echocardiograms were obtained in all patients to assess LVOT
gradient, adequacy of resection and degree of mitral insufficiency.
Over the past 40 years, surgical therapy has shown consistent improvement in symptoms and reduction of LVOT
gradient for patients with hypertrophic cardiomyopathy.