Impact of left ventricular outflow tract area on systolic outflow velocity in hypertrophic cardiomyopathy
A real-time three-dimensional echocardiographic study
Jian Xin Qin, MD*,
Takahiro Shiota, MD, PhD, FACC*,*,
Harry M. Lever, MD, FACC*,
David N. Rubin, MD*,
Fabrice Bauer, MD*,
Yong Jin Kim, MD*,
Marta Sitges, MD*,
Neil L. Greenberg, PhD*,
Jeanne K. Drinko, RDCS*,
Maureen Martin*,
Deborah A. Agler, RDCS* and
James D. Thomas, MD, FACC*
* Department of Cardiology, the Cleveland Clinic Foundation, Cleveland, Ohio, USA
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Figure 1 Real-time three-dimensional echocardiographic image obtained from parasternal window at midsystolic phase in a patient with hypertrophic cardiomyopathy. The right top and bottom images are parasternal long-axis and short-axis view images from B-scans, respectively. The left two images are the two parallel C-plane images (C1 and C2) obtained from cutting planes, which are shown on the right in green lines perpendicular to the long axis of the left ventricular outflow tract (LVOT). The area of the LVOT was traced shown in red in the three short-axis planes. The smallest area was counted as the area of LVOT in this particular systolic phase. Ao = aorta; LA = left atrium; LV = left ventricle.
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Figure 2 Pressure gradient (PG) across left ventricular outflow tract (LVOT) in the area of LVOT  2 cm2 and >2 cm2 groups. 3DE = three-dimensional echocardiography.
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Figure 3 The power correlations between maximal velocity across left ventricular outflow tract (LVOT) and area of LVOT (A) and systolic anterior motion of mitral valve leaflets (SAM)-septum distance (B). Vmax = maximal velocity through LVOT.
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