Heart failure & cardiomyopathies
Spatial relationship between mitral valve and ventricular septum assessed by resting echocardiography to diagnose left ventricular outflow tract obstruction in hypertrophic cardiomyopathy
Authors' conclusion
In our study, the novel echocardiographic parameter TIS showed high negative and positive predictive values for LVOTO in HCM.
Study context
- Population
- Consecutive patients with hypertrophic cardiomyopathy (HCM) at a referral centre (mean age 59 ± 13 years, 42% women)68 (42%) with left ventricular outflow tract obstruction (LVOTO)
- Participants
- 142 patients
- Comparison
- Resting echocardiographic TIS for LVOTO vs provocative manoeuvers
- Outcome
- Diagnostic performance of resting echocardiographic parameters for resting or provocable LVOTO (maximal LVOT gradient ≥30 mmHg)
Methodological detailsconsecutive patients, referral centre, blinded measurement
- Consecutive patients
- Referral centre
- Blinded measurement
Performance
As reported in the abstract
Resting or provocable LVOTO
| Strategy | Sensitivity | Specificity | PPV (rules in) | NPV (TIS >14 mm rules out) |
|---|---|---|---|---|
| TIS ≤ 14 mm | 97% | 57% | — not stated in the abstract | 95% |
| TIS ≤9 mm | 73% | 95% | 92% | — not stated in the abstract |
Sensitivity
TIS ≤ 14 mm97%
TIS ≤9 mm73%
Specificity
TIS ≤ 14 mm57%
TIS ≤9 mm95%
PPV (rules in)
TIS ≤ 14 mm— not stated in the abstract
TIS ≤9 mm92%
NPV (TIS >14 mm rules out)
TIS ≤ 14 mm95%
TIS ≤9 mm— not stated in the abstract
— not stated in the abstract
- AUC of TIS for LVOTO
- 0.91 (95% CI 0.87-0.96)
- TIS measurable in 3ch view
- 137 (96%)
- LVOTO among 43 patients with TIS 10–14 mm
- 35%
Original publication
Spatial relationship between mitral valve and ventricular septum assessed by resting echocardiography to diagnose left ventricular outflow tract obstruction in hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging. Published 26 February 2023. doi:10.
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