Author + information
- Received January 3, 2014
- Revision received January 15, 2014
- Accepted January 17, 2014
- Published online April 1, 2014.
- Hirotsugu Mihara, MD∗,
- Kentaro Shibayama, MD∗,
- Kenji Harada, MD∗,
- Javier Berdejo, MD∗,
- Yuji Itabashi, MD∗ and
- Takahiro Shiota, MD∗,†∗ ()
- ∗Noninvasive Cardiac Laboratory, Cedars-Sinai Heart Institute, Los Angeles, California
- †Department of Medicine, University of California–Los Angeles, Los Angeles, California
- ↵∗Address for correspondence:
Dr. Takahiro Shiota, Cedars-Sinai Heart Institute, 127 South San Vicente Boulevard A3411, Los Angeles, California 90048.
- discrete subaortic stenosis
- left ventricular outflow tract obstruction
Precise anatomical analysis of stenotic lesions of the left ventricular outflow tract (LVOT) in discrete subaortic membranous stenosis (DSS) and hypertrophic obstructive cardiomyopathy (HOCM) is challenging due to their complex nature (1,2). In the present study, we clarified the difference of the geometry and dynamic change of LVOT area using en face views of the LVOT in 6 patients with DSS and 6 patients with HOCM by real-time 3-dimensional transesophageal echocardiography. There was a conspicuous difference in LVOT velocity (Fig. 1) and geometry between DSS and HOCM: the LVOT shape was almost oval or flat in DSS, whereas there was a V shape or 2 separate open spaces in HOCM (Figs. 2 and 3, Online Videos 1 and 2). The magnitude of area change of the LVOT was less in DSS than in HOCM. The LVOT area was minimal in late systole in both DSS and HOCM in spite of the presence of an early peak in LVOT flow velocities in DSS versus a late peak in HOCM (Fig. 4).
For supplementary videos and their legends, please see the online version of this article.
Dr. Shiota is a speaker for Philips Ultrasound. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received January 3, 2014.
- Revision received January 15, 2014.
- Accepted January 17, 2014.
- American College of Cardiology Foundation
- Qin J.X.,
- Shiota T.,
- Lever H.M.,
- et al.