The DOI matches its Crossref record; 40 of the 40 references it cites were found in a registry or an index.
Hypertrophic Cardiomyopathy Is Predominantly a Disease of Left Ventricular Outflow Tract Obstruction
Abstract
Background— Nonobstructive hypertrophic cardiomyopathy (HCM) has been regarded as the predominant hemodynamic form of the disease on the basis of assessment of outflow gradient under resting conditions. We sought to prospectively define the prevalence, clinical profile, and significance of left ventricular (LV) outflow tract obstruction under resting conditions and with physiological exercise in a large HCM cohort. Methods and Results— We prospectively analyzed 320 consecutive HCM patients (age, 47±17 years), measuring LV outflow gradient at rest, with Valsalva maneuver, and with exercise echocardiography. LV outflow obstruction was present at rest and/or with exercise in 225 patients (70%); 119 had rest gradients ≥50 mm Hg and were not exercised. Of the other 201 patients with gradients <50 mm Hg at rest (average, 4±9 mm Hg), 106 developed mechanical obstruction to LV outflow resulting from mitral valve–septal contact after exercise (80±43 mm Hg), including 76 with marked gradients ≥50 mm Hg and 46 with heart failure symptoms. The remaining 95 patients (30%) had no or small gradients (<30 mm Hg) both at rest and with exercise. Valsalva maneuver underestimated the presence and magnitude of exercise-induced obstruction. Conclusions— Among those patients who come to clinical evaluation, HCM is a predominantly obstructive disease in which LV outflow gradients, frequently associated with heart failure symptoms and often identified only with exercise, are evident in most patients (ie, 70%). Identification of LV outflow obstruction with exercise echocardiography may broaden management options in HCM by identifying symptomatic patients not otherwise regarded as potential candidates for septal reduction therapy. Assessment of subaortic gradients with exercise should be a routine component of the evaluation of HCM patients without outflow obstruction under resting conditions.
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Citations
Cites
Hypertrophic Cardiomyopathy: A Systematic Review
Maron, B. J. (2002) · JAMA · doi:10.1001/jama.287.10.1308 · Cited by 2,224
Self-citationFletcher, G. F., Balady, G. J., Amsterdam, E. A., Chaitman, B., Eckel, R., Fleg, J., Froelicher, V. F., Leon, A. S., Piña, I. L., Rodney, R., et al. (2001) · Circulation · doi:10.1161/hc3901.095960 · Cited by 1,923
Maron, B. J., McKenna, W. J., Danielson, G. K., Kappenberger, L. J., Kuhn, H. J., Seidman, C. E., Shah, P. M., Spencer, W. H., Spirito, P., Ten Cate, F. J., et al. (2003) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(03)00941-0 · Cited by 1,578
Self-citationMaron, M. S., Olivotto, I., Betocchi, S., Casey, S. A., Lesser, J. R., Losi, M. A., Cecchi, F., & Maron, B. J. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa021332 · Cited by 1,259
Self-citationMagnitude of Left Ventricular Hypertrophy and Risk of Sudden Death in Hypertrophic Cardiomyopathy
Spirito, P., Bellone, P., Harris, K. M., Bernabò, P., Bruzzi, P., & Maron, B. J. (2000) · New England Journal of Medicine · doi:10.1056/nejm200006153422403 · Cited by 1,143
Self-citationThe Management of Hypertrophic Cardiomyopathy
Spirito, P., Seidman, C. E., McKenna, W. J., & Maron, B. J. (1997) · New England Journal of Medicine · doi:10.1056/nejm199703133361107 · Cited by 1,007
Self-citationSudden death in hypertrophic cardiomyopathy: identification of high risk patients
Elliott, P. M., Poloniecki, J., Dickie, S., Sharma, S., Monserrat, L., Varnava, A., Mahon, N. G., & McKenna, W. J. (2000) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(00)01003-2 · Cited by 978
Gobel, F. L., Norstrom, L. A., Nelson, R. R., Jorgensen, C. R., & Wang, Y. (1978) · Circulation · doi:10.1161/01.cir.57.3.549 · Cited by 866 · cited 2×
“Abnormal BP response, n (%) 24 (25) 14 (47) 23 (30) NS”
Ommen, S. R., Maron, B. J., Olivotto, I., Maron, M. S., Cecchi, F., Betocchi, S., Gersh, B. J., Ackerman, M. J., McCully, R. B., Dearani, J. A., et al. (2005) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2005.02.090 · Cited by 812
Self-citationHypertrophic Cardiomyopathy: Clinical Spectrum and Treatment
Wigle, E. D., Rakowski, H., Kimball, B. P., & Williams, W. G. (1995) · Circulation · doi:10.1161/01.cir.92.7.1680 · Cited by 778
Cited by
2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy
Authors/Task Force members, Elliott, P. M., Anastasakis, A., Borger, M. A., Borggrefe, M., Cecchi, F., Charron, P., Hagege, A. A., Lafont, A., Limongelli, G., et al. (2014) · European Heart Journal · doi:10.1093/eurheartj/ehu284 · Cited by 4,332
Self-citation2023 ESC guidelines for the management of cardiomyopathies
Arbelo, E., Protonotarios, A., Gimeno, J. R., Arbustini, E., Barriales-Villa, R., Basso, C., Bezzina, C. R., Biagini, E., Blom, N. A., de Boer, R. A., et al. (2023) · European Heart Journal · doi:10.1093/eurheartj/ehad194 · Cited by 2,844
Self-citationFletcher, G. F., Ades, P. A., Kligfield, P., Arena, R., Balady, G. J., Bittner, V. A., Coke, L. A., Fleg, J. L., Forman, D. E., Gerber, T. C., et al. (2013) · Circulation · doi:10.1161/cir.0b013e31829b5b44 · Cited by 2,235
Gersh, B. J., Maron, B. J., Bonow, R. O., Dearani, J. A., Fifer, M. A., Link, M. S., Naidu, S. S., Nishimura, R. A., Ommen, S. R., Rakowski, H., et al. (2011) · Circulation · doi:10.1161/cir.0b013e318223e2bd · Cited by 2,104
Self-citation2018 ESC Guidelines for the diagnosis and management of syncope
Brignole, M., Moya, A., de Lange, F. J., Deharo, J.-C., Elliott, P. M., Fanciulli, A., Fedorowski, A., Furlan, R., Kenny, R. A., Martín, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy037 · Cited by 1,951
Metadata
- Authors
- Maron, M. S., Olivotto, I., Zenovich, A. G., Link, M. S., Pandian, N. G., Kuvin, J. T., Nistri, S., Cecchi, F., Udelson, J. E., & Maron, B. J.
- Venue
- Circulation
- Published
- 2006-11-21
- Volume
- 114
- Issue
- 21
- Pages
- 2232-2239
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2153151839
- Cited by
- 1,123
- References
- 40
- FWCI
- 20.56
- Type
- journal article
- Language
- en
- Open access
- closed
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- Maron, M. S., Olivotto, I., Zenovich, A. G., Link, M. S., Pandian, N. G., Kuvin, J. T., Nistri, S., Cecchi, F., Udelson, J. E., & Maron, B. J. (2006). Hypertrophic Cardiomyopathy Is Predominantly a Disease of Left Ventricular Outflow Tract Obstruction. Circulation. https://doi.org/10.1161/circulationaha.106.644682
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
