ArticleArchives of medical science : AMS2015
Comparison of sublingual isosorbide dinitrate and Valsalva maneuver for detection of obstruction in hypertrophic cardiomyopathy.
Article in Archives of medical science : AMS, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 8 citations in OpenAlex.
- Dynamic right ventricular outflow tract obstruction due to straight back syndrome and funnel chest - A pediatric case.Journal of cardiology cases · 2024Article
- The Role of Nitroglycerin and Other Nitrogen Oxides in Cardiovascular Therapeutics.Journal of the American College of Cardiology · 2017Review
- Comparison of echocardiography with tissue Doppler imaging and magnetic resonance imaging with delayed enhancement in the assessment of children with hypertrophic cardiomyopathy.Archives of medical science : AMS · 2017Article
- Obstructive Form of Hypertrophic Cardiomyopathy-Left Ventricular Outflow Tract Gradient: Novel Methods of Provocation, Monitoring of Biomarkers, and Recent Advances in the Treatment.BioMed research international · 2016Review
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionA left ventricular outflow tract (LVOT) obstruction assessment with a provoking test should be a routine part of the evaluation of patients with hypertrophic cardiomyopathy (HCM). The aim of this study was to compare the utility of the Valsalva maneuver (VM) and sublingual spray application of isosorbide dinitrate (ISDN) for detection of an obstruction. MATERIAL AND
methodsWe prospectively evaluated 81 consecutive HCM patients without severe rest LVOT obstruction (defined as peak rest pressure gradient (PG) ≥ 50 mm Hg). We measured PG at rest, during the VM, after sublingual ISDN spray, and during the VM after ISDN. An obstruction was defined as a PG ≥ 30 mm Hg.
resultsAn obstruction was present in 15 patients (19%) at rest (median and interquartile range of PG 16 (7-26) mm Hg), in 38 patients (47%) during the VM (PG 28 (12-49) mm Hg), in 50 (62%) patients after ISDN (PG 50 (12-79) mm Hg), and in 55 patients (68%) during the VM after ISDN (PG 59 (20-87) mm Hg). The difference in occurrence of obstruction among different provoking tests was statistically significant for all comparisons (p < 0.001, except for the comparison of the ISDN test with the VM during ISDN, p = 0.025).
conclusionsThe ISDN test and the VM are useful screening methods for the detection of an HCM obstruction. Although ISDN appears to be more precise than the VM, the best option is a combination of both methods, which maximizes inducement of LVOT obstruction in patients with HCM.
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