title: Patient after renal transplantation with syncope: Role of echocardiography in upright position.
abstract: In Doppler echocardiography, testing left ventricular outflow tract (LVOT) gradient in the supine position (as is done in everyday practice) does not reflect the pathophysiology of this dynamic abnormality during the daily activities that trigger the symptoms (eg, syncope). LVOT obstruction is a dynamic phenomenon, strongly dependent on the left ventricular cavity size, geometric configuration of hypertrophy, load variability, contractility, and mitral apparatus abnormalities. LVOT gradient may develop not only in hypertrophic cardiomyopathy but also in various heart diseases. Recent investigations show that LVOT gradient should be measured also in the standing position. Here, we report the case of patient after renal transplantation, who developed LVOT gradient during orthostatic test. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:616-620, 2017.
authors.affiliation: 2nd Department of Cardiology, Jagiellonian University Medical College, ul. Kopernika 17, 31-501, Kraków, Polska.
authors.forename: Paweł Petkow
authors.identifier: http://orcid.org/0000-0002-7239-9044
authors.initials: PP
authors.lastname: Dimitrow
authors.affiliation: 2nd Department of Cardiology, Jagiellonian University Medical College, ul. Kopernika 17, 31-501, Kraków, Polska.
authors.forename: Danuta
authors.initials: D
authors.lastname: Sorysz
authors.affiliation: 2nd Department of Cardiology, Jagiellonian University Medical College, ul. Kopernika 17, 31-501, Kraków, Polska.
authors.forename: Rafał
authors.initials: R
authors.lastname: Hładij
authors.affiliation: 2nd Department of Cardiology, Jagiellonian University Medical College, ul. Kopernika 17, 31-501, Kraków, Polska.
authors.forename: Bernadeta
authors.initials: B
authors.lastname: Chyrchel
authors.affiliation: Chair and Department of Nephrology, Jagiellonian University Medical College, Kraków, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Dudzik
authors.affiliation: Chair and Department of Nephrology, Jagiellonian University Medical College, Kraków, Poland.
authors.forename: Władysław
authors.initials: W
authors.lastname: Sułowicz
authors.affiliation: 2nd Department of Cardiology, Jagiellonian University Medical College, ul. Kopernika 17, 31-501, Kraków, Polska.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Surdacki
mesh_terms: D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods*; D006801:Humans; D016030:Kidney Transplantation; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000209:etiology; D011187:Posture; D015203:Reproducibility of Results; D013575:Syncope / Q000209:etiology*; D014694:Ventricular Outflow Obstruction / Q000150:complications / Q000000981:diagnostic imaging*
keywords: left ventricular outflow tract gradient; stress echocardiography