title: Differences of postextrasystolic behavior of left ventricular and aortic pressures between fixed and dynamic left ventricular outflow tract stenosis.
abstract: The dynamic behavior of fixed LV outflow tract stenosis partly resembles that of OCM. To analyze their differences we studied basal and postextrasystolic (post-PVC) peak-to-peak LV aortic gradients, aortic systolic pressure, and pulse pressure in 14 OCM and in 36 pure VAS without two-dimensional echocardiographic findings of OCM. Fifteen mild VAS had basal gradients similar to those of OCM (39 +/- 17 mm Hg vs 24 +/- 16 mm Hg). Patients with OCM show a post-PVC gradient (109 +/- 41 mm Hg) similar to that of VAS (110 +/- 50 mm Hg). However, the latter were departing from much higher gradients (VAS 72 +/- 30 mm Hg vs OCM 24 +/- 16 mm Hg). Decrement of post-PVC aortic systolic pressure and pulse pressure were frequent in both groups, but decrement of pulse pressure greater than 5 mm Hg were more frequent in OCM. We concluded that (1) post-PVC increased aortic gradients and decreased aortic systolic pressure occurred in both VAS and OCM; (2) post-PVC decreased aortic pulse pressure might occur in VAS; and (3) association of post-PVC gradient increment greater than 75 percent and pulse pressure decrement greater than 5 mm Hg are strongly suggestive of OCM.
authors: Servei de Cardiologia Hospital General Vall d'Hebron, Barcelona, Spain.
authors: J
authors: J
authors: Angel
authors: E
authors: E
authors: Domingo
authors: R
authors: R
authors: Serrat
authors: I
authors: I
authors: Anivarro
authors: J
authors: J
authors: Soler-Soler
mesh_terms: D001024:Aortic Valve Stenosis / Q000503:physiopathology*; D005117:Cardiac Complexes, Premature / Q000503:physiopathology*; D002312:Cardiomyopathy, Hypertrophic / Q000503:physiopathology*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D014694:Ventricular Outflow Obstruction / Q000503:physiopathology*