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