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Relation between left ventricular outflow tract obstruction and left ventricular shape in patients with hypertrophic

Romain Martin1, Olivier Lairez, Nicolas Boudou

  • 1Department of Cardiology, Rangueil University Hospital, 1, avenue Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France; Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France.

Archives of Cardiovascular Diseases
|August 3, 2013
PubMed

Insights

Hypertrophic cardiomyopathy (HCM) involves left ventricular (LV) outflow tract obstruction. This study found specific LV and mitral valve angles are linked to obstruction in HCM patients.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Medical Research

Background:

  • Hypertrophic cardiomyopathies (HCM) are frequently linked to left ventricular (LV) outflow tract obstruction.
  • This obstruction can precipitate symptoms and influence patient prognosis.

Purpose of the Study:

  • To investigate the relationship between LV shape and outflow tract obstruction in HCM.
  • To elucidate the mechanisms connecting obstruction and cardiac morphology.

Main Methods:

  • Retrospective analysis of cardiac magnetic resonance (CMR) imaging in HCM patients.
  • Definition of obstructive HCM based on LV outflow gradient >30 mm Hg.
  • Assessment of LV shape and mitral valve angles using CMR, compared to controls.

Main Results:

  • Patients with obstructive HCM exhibited a smaller mean LV-mitral angle compared to non-obstructive HCM and control groups.
  • A larger mean mitral papillary muscle angle was observed in non-obstructive HCM patients versus obstructive HCM and controls.
  • Non-obstructive HCM patients showed a greater mean LV-aortic root angle than obstructive HCM and control subjects.

Conclusions:

  • Morphological and functional parameters in HCM are interrelated.
  • The mitral valve likely plays a role in the pathophysiology of obstructive hypertrophic cardiomyopathy.
Abstract

Keywords:
CMRCardiac magnetic resonance imagingCardiomyopathie hypertrophiqueGéométrie ventriculaire gaucheHCMHypertrophic cardiomyopathyImagerie par résonance magnétique cardiaqueLVLVARaLVMaLeft ventricular outflow tract obstructionLeft ventricular shapeMPMaMRIObstruction intraventriculaire gaucheSDcardiac magnetic resonancehypertrophic cardiomyopathyleft ventricularleft ventricular–aortic root angleleft ventricular–mitral anglemagnetic resonance imagingmitral papillary muscles anglestandard deviation

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