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[Analysis of left ventricular pulsus alternans in hypertrophic cardiomyopathy]

T Yamakado1, K Shiba, A Kasai

  • 1First Department of Internal Medicine, Mie University, Tsu.

Journal of Cardiology
|January 1, 1991
PubMed

Insights

Left ventricular pulsus alternans was observed in hypertrophic obstructive cardiomyopathy patients, suggesting potential left ventricular dysfunction. This phenomenon was not seen in non-obstructive cases.

Area of Science:

  • Cardiology
  • Cardiovascular Physiology

Background:

  • Hypertrophic cardiomyopathy (HCM) is a complex cardiac condition.
  • Assessing left ventricular (LV) pulsus alternans aids in understanding HCM pathophysiology.

Observation:

  • LV pulsus alternans was analyzed in 49 patients with HCM via cardiac catheterization.
  • Pulsus alternans was specifically noted in hypertrophic obstructive cardiomyopathy (HOCM) but not in hypertrophic non-obstructive cardiomyopathy (HNOCM).
  • The phenomenon was absent in the right ventricle and pulmonary artery.

Findings:

  • LV pulsus alternans occurred in 6 of 17 HOCM patients, with 5 showing a resting intraventricular pressure gradient.
  • No LV pulsus alternans was detected in any HNOCM patients.
  • Minimal pulsus alternans was observed in low-pressure LV segments and peripheral arteries during high-pressure chamber pulsus alternans.

Implications:

  • LV pulsus alternans in HOCM may indicate left ventricular dysfunction.
  • Increased afterload is a potential contributing factor to LV pulsus alternans in HOCM.
  • Further research into pulsus alternans as a marker for LV dysfunction in HCM is warranted.

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