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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina

 

RELIABILITY OF SOME TTE AND TEE PARAMETERS IN ASSESSMENT OF LVOT OBSTRUCTION IN HOCM
M. Bukša, R. Erbel N. Naser, M. Kulić, S. Brđanović and A. Saračević.
Clinic of Heart Diseases and Rheumatisms, Clinical Center University of Sarajevo, The Second Medical Clinic, University-Mainz, Bosnia and Herzegovina, Germany

Introduction: Pressure gradients are the most reliable parameter of assessment of the left ventricular outflow tract (LVOT) obstruction in hypertrophic cardiomyopathy (HOCM). The aim was to assess the correlation between the peak gradient (PG) of LVOT and some other parameters measured by transthoracic (TTE) and transesophageal (TEE) ehocardiography. Methods and materials: Eleven patients were studied, with average 38 yrs. (range 22 to 70 yrs.). In all patients TTE and biplane TEE were performed. The PG of LVOT was correlated with the end-diastolic thickness of the IVS, the shortest distance between SAM and IVS, the mitral regurgitation area of one or two jets (MRA), and the lentgh of mitral regurgitation jets (MRL) measured by TTE and TEE. Results: Multivariate analysis of the parameters showed that the best negative correlation ranks were found between PG and the shortest distance between SAM and IVS: in parasternal M-mode the correlation was best negative (r=-.85), in TEE it was very good (r =-.83), and in TTE apical view the correlation was r=-.74. In four patients contact between IVS and SAM was found, with different contact time in M-mode. Better correlation beetwen PG and MRL was found by TEE (r=.79) then by TTE (r=.72). Correlations between PG and MRA were better by TEE (r=.75), then by TTE apical four chambers view (r=.69). Correlation between PG and IVS thickness was good in parasternal M-mode (r=.65), while it was less satisfactory in TEE (r=.56), and by TTE was found (r=.45). Conclusions: The shortest distance between SAM and IVS can be rather reliable parameter in assessement of LVOT obstruction. MRA and MRL are less reliable parameter, while thickness of IVS in M-mode showed a good correlation, but it was less in TEE and the least significant in apical TTE view.
Keywords:TTE,TEE, HOCM, LVOT, IVS, MRA,MRL .

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