Dobutamine stress echocardiography for assessing the role of dynamic intraventricular obstruction in left ventricular ballooning syndrome

Cardiovascular Ultrasound

Research

Rita Camporotondo¹  Alessandra Repetto¹  Stefania Panigada¹  Mario Previtali¹ 

[1] From Department of Cardiology, IRCCS Fondazione Policlinico San Matteo, University of Pavia School of Medicine, Pavia, Italy;

关键词: Mitral Regurgitation;    Dobutamine Stress Echocardiography;    Regional Wall Motion Abnormality;    Coronary Artery Spasm;    Wall Motion Score Index;   

DOI  :  10.1186/1476-7120-8-11

 received in 2010-01-22, accepted in 2010-04-09,  发布年份 2010

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY   
© Previtali et al; licensee BioMed Central Ltd. 2010