Echocardiographic characteristics predicting efficacy of drug therapy in patients with hypertrophic obstructive cardiomyopathy.

Abstract

BACKGROUND:

The efficacy of long-term drug therapy for patients with hypertrophic obstructive cardiomyopathy (HOCM) remains unclear. This study was performed to characterize the echocardiographic findings of patients responsive to drug therapy.

METHODS:

Left ventricular outflow tract (LVOT) gradient and morphologic characteristics of the septum, posterior wall, and mitral valve were measured echocardiographically in 35 Japanese patients. The mean follow-up time was 41+/-22 months.

RESULTS:

Long-term drug therapy was effective in 14 patients and ineffective in 21 patients. Five of the refractory patients required mitral valve replacement to become free of symptoms. Only 5 of 21 patients whose LVOT gradient was 100 mm Hg were responsive to drug therapy, whereas 9 of 14 patients whose LVOT gradient was <100 mm Hg were responsive to drug therapy. Seven of eight patients with an asymmetric septal hypertrophy (ASH) ratio >==1.3 and LVOT gradient <100 mm Hg were responsive to drug therapy. Only 3 of 16 patients with an ASH ratio <1.3 were responsive to drug therapy. There was no correlation between the efficacy of drug therapy and the morphology of the mitral valve or the width of the LVOT.

CONCLUSION:

Our results demonstrate that drug therapy effectively reduces the LVOT gradient in patients with asymmetric septal hypertrophy and a less severe LVOT gradient.

• Authors: Kazuhiro Shimaya, Akira Kurihashi, Yuji Fuda, Toshitaka Yajima, Nobuo Yamami, Tsuyoshi Shiga, Yasunari Sakomura, Naoki Matsuda, Naoko Ishizuka, Hiroshi Kasanuki
• Journal: International journal of cardiology (Int J Cardiol) Vol. 98 Issue 1 Pg. 141-5 (Jan 2005) ISSN: 0167-5273 [Print] Netherlands
• PMID: 15676178 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Cardiomyopathy, Hypertrophic (diagnostic imaging, drug therapy)
• Echocardiography
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Mitral Valve (diagnostic imaging)
• Predictive Value of Tests
• Severity of Illness Index
• Treatment Outcome
• Ventricular Outflow Obstruction (diagnostic imaging, drug therapy)