Dobutamine stress echocardiography for assessing the role of dynamic intraventricular obstruction in left ventricular ballooning syndromeReport as inadecuate




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Cardiovascular Ultrasound

, 8:11

First Online: 09 April 2010Received: 22 January 2010Accepted: 09 April 2010

Abstract

BackgroundDynamic intraventricular obstruction has been observed in patients with left ventricular ballooning syndrome LVBS and has been hypothesized as a possible mechanism of the syndrome. The aim of this study was to assess the prevalence and significance of dynamic intraventricular obstruction in patients with LVBS.

Methods and ResultsDobutamine stress echocardiography was carried out in 22 patients with LVBS 82% apical, all women, aged 68 ± 9 years. At baseline 1 patient had a > 30 mmHg LV gradient; during stress a LV gradient > 30 mm Hg developed in 6-21 patients 28% and was caused by systolic anterior motion of the mitral valve in the 3 patients with severe gradient mean 116 ± 29 mmHg, who developed mitral regurgitation and impaired apical wall motion and by obstruction at mid-ventricular level in the other 3 with a moderate gradient mean 46 ± 16 mmHg. Compared with patients without obstruction those with obstruction had a greater mean septal thickness 11.6 ± .6 vs 9.8. ± 3, p < .01, a higher prevalence of septal hypertrophy 71% vs 7%, p < .005 and a higher peak wall motion score index 1.62 ± .4 vs 1.08 ± .4, p < .01.

ConclusionSpontaneous or dobutamine-induced dynamic LV obstruction is documented in 32% of patients with LVBS, is correlated with the presence of septal hypertrophy and may play a role in the development of LVBS in this subset of patients. In those without septal hypertrophy a dynamic obstruction is rarely induced with dobutamine and is unlikely to be a major pathogenetic factor of the syndrome.

Electronic supplementary materialThe online version of this article doi:10.1186-1476-7120-8-11 contains supplementary material, which is available to authorized users.

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Author: Mario Previtali - Rita Camporotondo - Alessandra Repetto - Stefania Panigada

Source: https://link.springer.com/article/10.1186/1476-7120-8-11







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