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Emerging Risk Factors for Coronary Heart Disease

1996; Oxford University Press; Volume: 17; Issue: suppl 5 Linguagem: Inglês

10.1093/eurheartj/17.suppl_5.509

1522-9645

Y Pansard, I Henry, D. Chatel, Arezki Hadj-Ali, C Lenoimand, C Paidole, J Langlols, U Hvass, T. McDonagh, C Morrison, John J.V. McMurray, Hugh Tunstall‐Pedoe, Kenneth E.L. McColl, H. J. Dargie, B J Rathbone, Daniel Martín, Jonathan Stephens, John R. Thompson, Nilesh J. Samani,

Cardiovascular Health and Risk Factors

LJtde is known about the long term echocardtographic outcome (>2 years) of HOCM patients treated by BIgelow-Morrow intervention (BMI).We studied 11 patients (7 M, 4F) who had a preoperative (PO), early post-operative (EPO) and late post-operative (at least 2 years after BMI: 2-11.5 years) (LPO) echocarcftography.We studied by doppler the eflect of BMI on subaortic pressure gradient (PG) and the following parameters: end dlastolic (EDD) and end systolic diameters (ESD), septum (SP) and posterior (PW) wafl thickness, persistence of systolic anterior mitral valve movement (SAM).The mean long term outcome was 5.9 ± 3.3 years (2-11.5).The results are shown In the table: EDD ESD SP PW PO 42.72 ± 4.07 EPO 42.12 ±2.69 LPO 47.27 ±4.75 25.27 ±2.31 28.25 ±4 48 32.36 ±5.93 21.42 ±4.67 17 75±2.5515.45±1.9613.72 ±3.52 11.37 ± 1.76 1090±1.70There was no significant modification between PO and EPO EDD and ESD.The LPO EDD and ESD were significantly higher than the PO EDD and ESD (respectively p « 0.013 and p -0.015).ESD seems to progress in time in the same way as EDD.EPO SP, LPO SP and LPO PW thicknesses were signlflcantfy diminished, compared with the PO one (respectivery p -0.016, p -0.0002 and p -0.015).Pre-and post-operative SP/PW ratio were not significantly diferent There was no more PG in 7 patients (63.6%), a maximal residual PG in 4 patients (21.25 ± 34.02 mmHg).The difference between PO and LPO PG was highly significant (p -0.0003).A SAM persisted in 3 patients.In conclusion, EDD and ESD increased and septal wall thickness diminished a long time after BMI.There is a left ventricular remodelling after dynamic subaortic obstacle suppression.Obstacle suppression seems to be the trigger of the ventricular diameter modifications, which become significant after a mean 5 year follow-up.Myotomy does not seem to explain Itself the left ventricular diameters Increase.BMI seems to operate on dynamic obstruction and on left ventricular morphology: the left verrtricule tends to increase its diameters and to become thiner.