Background: Earlier studies demonstrated the ability of real-time 3-dimensional (3D) echocardiography (3DE) to measure left ventricular outflow tract (LVOT) area (ALVOT) in patients with hypertrophic cardiomyopathy (HCM). However, its clinical value is unknown. Objective: We sought to investigate the feasibility and accuracy of real-time 3DE-derived ALVOT to diagnose significant LVOT obstruction in a large number of patients with HCM. Methods: A total of 162 patients with HCM had 3DE by using a volumetric system. The smallest ALVOT during systole was determined by moving a 2-dimensional plane in 3D space. The pressure gradient across LVOT was assessed by continuous wave Doppler method. Provocation was performed in patients without significant LVOT obstruction (pressure gradient across LVOT < 50 mm Hg) at rest. Results: Twenty (12%) patients with poor image quality of 3DE were excluded; 16 (28%) patients with a volumetric system, but only 4 (4%) patients with commercial equipment (P < .001). In the remaining 142 patients, ALVOT inversely correlated with pressure gradient across LVOT both at rest (r = 0.82, P < .001) and after provocation (r = 0.60, P < .001). The value of ALVOT less than 0.85 cm2 and less than 2.0 cm2 predicted resting and provokable LVOT obstruction with sensitivity of 87% and 81%, and specificity of 77% and 90%, respectively. Conclusions: Real-time 3DE measurement of ALVOT was successful in diagnosing and quantifying LVOT obstruction at rest and after provocation in a large number of patients with HCM.
|Original language||English (US)|
|Number of pages||7|
|Journal||Journal of the American Society of Echocardiography|
|State||Published - Jul 2008|
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine