OBSTRUCTIVE HYPERTROPHIC CARDIOMYOPATHY: 6-MONTH DYNAMICS OF CLINICAL AND ECHOCARDIOGRAPHIC PARAMETERS AFTER MYECTOMY
Abstract
The study included 43 patients with obstructive HCM who underwent surgical myectomy. The mean age of the patients was 43.5 years (33–56); 28 (65.1%) were men and 15 (34.9%) were women, with a male-to-female ratio of 1.87:1. A comprehensive assessment was performed before surgery and 6 months after the intervention. The left ventricular outflow tract (LVOT) pressure gradient, interventricular septal thickness (IVST), left ventricular myocardial mass, ejection fraction (EF), parameters of diastolic function (E/A, E/e′, e′), presence of systolic anterior motion (SAM) of the mitral valve, NT-proBNP levels, and 6-minute walk test results were evaluated. Paired Student’s t-test and McNemar’s exact test were used to compare paired measurements. A p-value <0.05 was considered statistically significant. Six months after myectomy, a marked improvement in the principal hemodynamic parameters was observed. The LVOT gradient decreased from 78.4±25.7 to 13.5±7.8 mmHg (p<0.01). The prevalence of SAM decreased from 36 (83.7%) to 6 (16.7%) patients (p<0.01). Interventricular septal thickness decreased from 22.18±5.75 to 15.23±3.30 mm (p<0.01), while left ventricular myocardial mass decreased from 307.2±33.5 to 245.2±32.8 g (p<0.01). An improvement in diastolic function was observed: E/A increased from 0.89±0.29 to 1.06±0.10, whereas E/e′ decreased from 11.60±1.68 to 10.37±1.04 (p<0.01). NT-proBNP levels decreased from 1339.9±556.4 to 740.5±456.4, while the distance covered during the 6-minute walk test increased from 306.0±45.0 to 388.2±60.7 m (p<0.01). Ejection fraction decreased from 68.3±5.8% to 62.2±5.0% (p<0.01), concomitant with marked relief of LVOT obstruction and favorable changes in other clinical and hemodynamic parameters.
Publication Details
This article is licensed under a Creative Commons Attribution 4.0 International License.