Pulmonary venous flow in hypertrophic cardiomyopathy as assessed by the transoesophageal approach. The additive value...

Area of Science:

• Cardiology
• Cardiovascular Physiology
• Echocardiography

Background:

• Hypertrophic cardiomyopathy (HCM) is characterized by left ventricular hypertrophy.
• Understanding transmitral flow patterns is crucial for assessing diastolic function in HCM.
• Pulmonary venous (PV) flow dynamics offer insights into left atrial (LA) function and filling pressures.

Purpose of the Study:

• To characterize PV flow patterns in HCM patients.
• To investigate the interaction between PV flow, LA function, and mitral inflow.
• To identify predictors of pseudonormal mitral inflow patterns in HCM.

Main Methods:

• Transesophageal echocardiography evaluated PV and mitral inflow in 80 HCM patients and 35 controls.
• Transthoracic echocardiography assessed LA size and function.
• Regression analyses identified predictors of mitral E/A ratio and pseudonormal patterns.

Main Results:

• HCM patients exhibited increased atrial reversal flow and longer deceleration times compared to controls.
• A wide variability in PV flow patterns was observed among HCM patients.
• PV flow parameters, LA volume, and systolic fraction predicted mitral E/A ratio (r=0.82); PV flow and LA volume predicted pseudonormal patterns (83% sensitivity, 90% specificity).

Conclusions:

• PV flow variability correlates with transmitral flow patterns in HCM.
• Mitral regurgitation severity did not independently predict pseudonormal mitral inflow.
• PV flow and LA size are valuable for interpreting mitral inflow and assessing elevated LV filling pressures in HCM.