title: [Hypertrophic cardiomyopathy: distribution of the hypertrophy evaluated by bidimensional echocardiography and observations on the genesis of the obstruction].
abstract: Two-dimensional echocardiography (2-DE) was performed in 38 patients with hypertrophic cardiomyopathy (HCM) in order to study the distribution of hypertrophy. Its importance in the genesis of the obstruction was evaluated in 26 of these patients who also underwent cardiac catheterization. The hypertrophy was confined to the septum only in 14 patients (37%) and involved both septum and free wall in 24 patients (63%). In the 26 patients who underwent cardiac catheterization, extensive hypertrophy (septum + free wall) was found in 16 of 18 patients with a pressure gradient and in 3 of 8 patients without a pressure gradient. Systolic anterior motion of mitral valve (SAM) was present in all patients with extensive hypertrophy and a pressure gradient. Three patients without a pressure gradient had systolic anterior motion of mitral valve. The two-dimensional echocardiographic finding of systolic cavity elimination was present in 7 of 18 patients with pressure gradient and in none of the patients without. We conclude that in hypertrophic cardiomyopathy: Septal hypertrophy is always present and also involves the free wall in a high percentage of the patients (63%). The data are in agreement with previous observation, apart from isolated free wall hypertrophy which was not seen in our series. The presence of extensive hypertrophy involving the free wall seems to be an essential determinant of a gradient. Systolic anterior motion of mitral valve seems to be the most sensitive (sensitivity = 89%) and cavity elimination the most specific (specificity = 100%) echocardiographic sign of outflow pressure gradient.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002312:Cardiomyopathy, Hypertrophic / Q000473:pathology* / Q000503:physiopathology; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
vernacular_title: Cardiomiopatia ipertrofica: distribuzione dell'ipertrofia valutata con ecocardiografia bidimensionale ed osservazioni sulla genesi dell'ostruzione.