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Left-ventricular outflow tract acceleration time is associated with symptoms in patients with obstructive

Roy Huurman1, Michelle Michels2, Daniel J Bowen2

  • 1Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40, Post Office box: 2040, 3015 GD, Rotterdam, The Netherlands. r.huurman@erasmusmc.nl.

Journal of Ultrasound
|July 27, 2020
PubMed

Insights

In obstructive hypertrophic cardiomyopathy (HCM), increased left-ventricular outflow tract (LVOT) acceleration time (AT) is linked to patient symptoms. This easily measured echocardiographic variable shows excellent reproducibility and aids in assessing symptomatic status.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiovascular Disease

Background:

  • Obstructive hypertrophic cardiomyopathy (HCM) presents a spectrum of symptomatic experiences, with the relationship between disease severity and symptoms not fully elucidated.
  • Understanding factors contributing to symptoms in obstructive HCM is crucial for patient management and risk stratification.

Purpose of the Study:

  • To investigate the association between left-ventricular outflow tract (LVOT) acceleration time (AT) and symptomatic status in patients with obstructive HCM.
  • To determine if AT is an independent predictor of symptoms in this patient population.

Main Methods:

  • A cohort of 187 obstructive HCM patients underwent echocardiographic assessment, measuring LVOT acceleration time (AT), peak velocity (PV), and left-ventricular ejection time (ET).
  • Logistic and Cox proportional hazard regression analyses were employed to correlate AT with symptomatic status (NYHA class ≥II) and clinical outcomes.
  • Reproducibility of AT measurements was evaluated using the intraclass correlation coefficient (ICC).

Main Results:

  • Symptomatic patients exhibited higher mean AT values compared to asymptomatic individuals.
  • Logistic regression revealed a significant association between increased AT and symptomatic status, even after adjusting for confounding factors (OR 1.31 per 10 ms, p < 0.01).
  • AT was independently associated with symptoms and the need for septal reduction therapy during follow-up (HR 1.09 per 10 ms, p < 0.05), with high inter-reader reproducibility (ICC = 0.98).

Conclusions:

  • Increased left-ventricular outflow tract acceleration time (AT) is significantly related to symptomatic status in obstructive HCM patients.
  • AT is a valuable, easily measurable echocardiographic parameter with excellent reproducibility for assessing symptoms and guiding management in obstructive HCM.
Abstract

Keywords:
Acceleration time, symptomsHypertrophic cardiomyopathyObstruction

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