Related Experiment Video

Updated: Sep 9, 2025

Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
07:11

Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography

Published on: October 28, 2020

3.0K

Mildly elevated left ventricular outflow tract gradients are associated with increased short-term mortality in

Moran Gvili Perelman1, Michal Laufer-Perl1, Ariel Banai1

  • 1Division of Cardiology, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel; Tel Aviv University, Tel Aviv, Israel.

International Journal of Cardiology
|August 31, 2025
PubMed

Insights

Elevated left ventricular outflow tract gradients (LVOTG) in hospitalized patients without septal hypertrophy predict short-term mortality. Even mild increases in LVOTG are associated with higher in-hospital and 30-day mortality rates.

Area of Science:

  • Cardiology
  • Echocardiography
  • Internal Medicine

Background:

  • Left ventricular outflow tract (LVOT) obstruction is influenced by anatomical and physiological factors.
  • The role of elevated LVOT gradients (LVOTG) in patients without septal hypertrophy is not well understood, especially in hospitalized individuals.
  • Hypertrophic cardiomyopathy (HCM) is a known cause of LVOT obstruction, but this study focuses on non-HCM patients.

Purpose of the Study:

  • To investigate the association between elevated LVOTG and short-term mortality in hospitalized patients without septal hypertrophy.
  • To determine if mild elevations in LVOTG predict adverse outcomes in this specific patient population.
  • To explore the clinical, echocardiographic, and laboratory factors associated with elevated LVOTG.

Main Methods:

  • Retrospective observational study of 27,478 inpatients without septal hypertrophy.
  • Assessment of LVOTG and its association with short-term mortality using multivariate logistic regression.
  • Cohort stratified into three groups based on LVOTG levels (0-6 mmHg, 6-10 mmHg, >10 mmHg) for comparative analysis.

Main Results:

  • Mild LVOTG elevation (≥ 6 mmHg) was present in 10.1% of the cohort, linked to increased in-hospital and 30-day mortality.
  • Patients with LVOTG >10 mmHg had the highest mortality risk (OR 2.5), while those with 6-10 mmHg also showed increased risk (OR 1.4).
  • Elevated LVOTG correlated with increased septal thickness, smaller left ventricular size, higher C-reactive protein, lower hemoglobin, and increased ejection fraction.

Conclusions:

  • Mild elevation in LVOTG is a predictor of short-term mortality in hospitalized patients lacking septal hypertrophy.
  • These findings highlight the importance of assessing LVOTG even in the absence of significant septal thickening.
  • LVOTG may represent a crucial, yet underappreciated, marker for adverse outcomes in this patient group.
Abstract

Keywords:
LVOT obstructionLVOTOLeft ventricular outflow tract gradient

More Related Videos

Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs14:35

Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs

Published on: April 17, 2021

8.6K
Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery04:48

Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery

Published on: November 28, 2018

8.0K

Related Concept Videos

Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
34
Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
55
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
45
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
52
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
37
Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.5K