PMID- 10520801
OWN - NLM
STAT- MEDLINE
DCOM- 19991027
LR  - 20190708
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 34
IP  - 4
DP  - 1999 Oct
TI  - Changes in left ventricular filling and left atrial function six months after 
      nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy.
PG  - 1123-8
AB  - OBJECTIVES: The purpose of this study was to evaluate changes in left ventricular 
      (LV) filling, left atrial (LA) volumes and function six months after nonsurgical 
      septal reduction therapy (NSRT) for hypertrophic obstructive cardiomyopathy 
      (HOCM). BACKGROUND: Patients with HOCM frequently have enlarged left atria, which 
      predisposes them to atrial fibrillation. Nonsurgical septal reduction therapy 
      results in significant reduction in left ventricular outflow tract (LVOT) 
      obstruction and symptomatic improvement. However, its effect on LV passive 
      filling volume, LA volumes and function is not yet known. METHODS: Thirty 
      patients with HOCM underwent treadmill exercise testing as well as 2-dimensional 
      and Doppler echocardiography before and six months after NSRT. Data included 
      clinical status, exercise duration, LVOT gradient, mitral regurgitant (MR) 
      volume, LV pre-A pressure and LA volumes. Left atrial ejection force and kinetic 
      energy (KE) were computed noninvasively and were compared with 12 age-matched, 
      normal subjects. RESULTS: New York Heart Association (NYHA) class was lower and 
      exercise duration was longer (p < 0.05) six months after NSRT. The LVOT gradient, 
      MR volume and LV pre-A pressure were all significantly reduced. HOCM patients had 
      larger atria, which had a higher ejection force and KE, compared with normal 
      subjects (p < 0.01). After NSRT, LV passive filling volume increased (p < 0.01), 
      whereas LA volumes, ejection force and KE decreased (p < 0.01). Reduction in LA 
      maximal volume was positively related to changes in LV pre-A pressure (r = 0.8, p 
      < 0.05) and MR volume (0.4, p < 0.05). Changes in LA ejection force were 
      positively related to changes in LA pre-A volume (r = 0.7, p < 0.01) and KE (r = 
      0.81, p < 0.01). The increase in exercise duration paralleled the increase in LV 
      passive filling volume (r = 0.85, p < 0.05). CONCLUSIONS: Nonsurgical septal 
      reduction therapy results in an increase in LV passive filling volume and a 
      reduction in LA size, ejection force and KE.
FAU - Nagueh, S F
AU  - Nagueh SF
AD  - Department of Medicine, Baylor College of Medicine, Houston, Texas 77030, USA. 
      sherifn@bcm.tmc.edu
FAU - Lakkis, N M
AU  - Lakkis NM
FAU - Middleton, K J
AU  - Middleton KJ
FAU - Killip, D
AU  - Killip D
FAU - Zoghbi, W A
AU  - Zoghbi WA
FAU - Quinones, M A
AU  - Quinones MA
FAU - Spencer, W H 3rd
AU  - Spencer WH 3rd
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Atrial Function, Left/*physiology
MH  - Cardiac Volume/physiology
MH  - Cardiomyopathy, Hypertrophic/diagnostic imaging/physiopathology/*therapy
MH  - Echocardiography
MH  - Echocardiography, Doppler
MH  - Exercise Test
MH  - Female
MH  - Follow-Up Studies
MH  - *Heart Septum/diagnostic imaging/physiopathology
MH  - Hemodynamics/*physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Stroke Volume/physiology
MH  - Treatment Outcome
MH  - Ventricular Function, Left/*physiology
EDAT- 1999/10/16 09:00
MHDA- 2001/03/28 10:01
CRDT- 1999/10/16 09:00
PHST- 1999/10/16 09:00 [pubmed]
PHST- 2001/03/28 10:01 [medline]
PHST- 1999/10/16 09:00 [entrez]
AID - S0735-1097(99)00341-1 [pii]
AID - 10.1016/s0735-1097(99)00341-1 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 1999 Oct;34(4):1123-8. doi: 10.1016/s0735-1097(99)00341-1.