Progression of hypertrophic cardiomyopathy. A cross sectional echocardiographic study.

Abstract

SUMMARY The progression of hypertrophy was studied in 39 patients with hypertrophic cardiomyopathy by echocardiography at follow up from January 1979 to September 1983 (mean follow up 42 months). Thirty two patients were treated medically and 11 had had a septal myotomymyectomy. Progression of the hypertrophy was noted in four patients treated with propranolol. An additional region in the left ventricular long axis plane was affected in two, extending to the apical region in one and to the basal region in the other, and an additional segment in the left ventricular short axis plane in two extending from the septum into the free wall. The electrocardiograms of these four patients showed a significant increase in QRS voltages (Sokolow-Lyon index increase > 10 mm) and of the Romhilt-Estes score (increase -3 points) in two, development of a left bundle branch block in one, and no change in one. Progression of hypertrophy was seen in none of the 11 patients treated with myotomy-myectomy.Thus echocardiography accurately detects the progression of hypertrophy in patients with hypertrophic cardiomyopathy, which may be prevented by septal myotomy-myectomy.With echocardiography the familial occurrence of hypertrophic cardiomyopathy,' -3 its morphological4-6 and functional aspects,7-9 and the effects of medical' 0-1 2 and surgical treatment can be studied.'3 14Based on the patterns of distribution of the hypertrophy, classification into subtypes of hypertrophic cardiomyopathy has been proposed. I 16 The progression of hypertrophy has been assessed in patients by electrocardiography,'7 but because of its low sensitivity and specificity in detecting hypertrophy in these patients'8 this method may not be useful for studying its progression. The aim of this study was to investigate by serial electrocardiography and cross sectional echocardiography whether or not progression of hypertrophy occurs in hypertrophic cardiomyopathy. Patients and methods STUDY GROUPSTwo groups of patients with hypertrophic car-

Changes of the Degree of Hypertrophy in Hypertrophic Obstructive Cardiomyopathy under Medical and Surgical Treatment

“…In these studies as well as in a further investigation [26], which was only evaluated qualitatively, patients with obstructive and nonobstructive cardiomyopathy were in cluded. In addition, no distinction was made in terms of pharmacotherapy.…”

Electrocardiographic Abnormalities in Hypertrophic Cardiomyopathy: Its Relation to the Extent of Myocardial Hypertrophy

“…The new methods of study, and in particular twodimensional (2D) echocardiography, have greatly contrib uted to the diagnosis of hypertrophic cardiomyopathy and to the interpretation of its morphological and physiopathological aspects [1][2][3][4][5], Still nowadays, however, the sim ple ECG plays a role in the first diagnostic screening of this disease, even if we have been unable so far to under-I -Septal hypertrophy: localized at the anterior and/or posterior segment of the ventricular septum, usually in the basal region but often in the basal, middle and apical region. In these cases, the free wall thickness was smaller than 15 mm.…”

Left Ventricular Remodeling in Hypertrophic Cardiomyopathy: An Overview of Current Knowledge

“…However, in 1985, Domenicucci and colleagues presented results from a cohort of 39 adult HCM patients, among whom four showed mild positive remodeling (the four patients being 17, 49, 49, and 53 years of age) [ 36 ]. More recently, Doolan and colleagues have reported findings from serial echocardiographic evaluations in a cohort of 62 HCM patients [ 37 ].…”