(Circulation. 1999;99:344-347.)
© 1999 American Heart Association, Inc.
Brief Rapid Communications |
Changes in Left Ventricular Diastolic Function 6 Months After Nonsurgical Septal Reduction Therapy for Hypertrophic Obstructive Cardiomyopathy
From the Department of Medicine, Cardiology Section, Baylor College of Medicine, Houston, Tex.
Correspondence to Sherif F. Nagueh, MD, Cardiology Section, Baylor College of Medicine, 6550 Fannin, SM1246, Houston, TX 77030. E-mail sherifn{at}bcm.tmc.edu
Abstract
Background—Nonsurgical septal reduction therapy (NSRT) decreases left ventricular outflow tract (LVOT) gradient and improves symptoms in patients with hypertrophic obstructive cardiomyopathy (HOCM). NSRT effects on LV/left ventricular diastolic function are currently unknown.
Methods and Results—HOCM patients (n=29) had Doppler
echocardiography at baseline and 6 months after
NSRT to evaluate changes in LV volume, pre–A-wave pressure,
early diastolic mitral annulus velocity (Ea) by tissue
Doppler, and 
. At 6 months, a significant reduction in LVOT
gradient (from 53.6±15 to 6±5 mm Hg; P<0.001) was
accompanied by improvement in exercise duration (from 284±147 to
408±178 seconds; P=0.04) and New York Health Association
class (from III to I; P<0.001). Pre-A pressure (18±6 to
14±5 mm Hg; P<0.01) and (62±8 to 51±8 ms;
P<0.01) decreased, whereas Ea (5.8±1.8 to 8±1.8 cml/s;
P<0.01) and LV end-diastolic volume (117±16 to
130±22 mL; P<0.01) increased.
Conclusions—NSRT improves LV relaxation and compliance, which contributes to the symptomatic relief seen at 6 months.
Key Words: diastole • cardiomyopathy • hypertrophy • echocardiography
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