LVOTGLeft Ventricular Outflow Tract Gradient
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In previous HCM studies, measurements of hsTn were only at a resting (without stress in unnatural condition) echocardiography and not timely synchronized with maneuvers to provoke LVOTG by natural stimuli reflecting daily common physical activity for patients [5-8].
This protocol seems to be reasonable because hs-TnI levels may be related with labile, dynamic nature of LVOTG with fluctuating peaks in daytime (provoked LVOTG as a potential cause of myocardial ischemia).
In contrast, we have assessed LVOTG more precisely as a continuous variable, measured both at rest and after provocation (the provocable LVOTG is absolutely needed to measure risk of SCD by ESC calculator).