Electrocardiographic and echocardiographic characteristics of patients with hypertrophic obstructive cardiomyopathy at one year after left ventricular outflow tract dredging

Abstract

Abstract:

ObjectiveTo investigate the changes and characteristics of electrocardiogram and echocardiography in patients with hypertrophic obstructive cardiomyopathy at 1 year after left ventricular outflow tract dredging.MethodsTo investigate patients diagnosed with hypertrophic obstructive cardiomyopathy who underwent left ventricular outflow tract dredging surgery in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 1 to December 31 in 2018. A total of 38 cases were enrolled, the clinical features, electrocardiogram and echocardiography data before, 1 year after surgery were collected for comparative analysis and summarizations.ResultsThere were significant statistical differences in the proportion of left ventricular hypertrophy (LVH) and complete left bundle branch block (CLBBB) on electrocardiogram (52.6%vs12.9%,P<0.01) and (2.6%vs58.1%,P<0.01), respectively. Echocardiography showed a significant reduction in left ventricular ejection fraction (LVEF) (68.50%±4.11%vs63.87%±4.00%,P<0.01). In post-surgery patients with CLBBB (67.46%±2.96%vs64.83%±4.20%,P=0.082), there was a significant reduction in LVEF (69.39%±5.29%vs63.40%±4.15%,P<0.01), while there was no statistical difference in patients without CLBBB.ConclusionsLeft ventricular outflow tract dredging surgery could effectively reduce the proportion of LVH in patients with hypertrophic obstructive cardiomyopathy and alleviate outflow tract obstruction. However, patients who developed CLBBB after surgery showed a tendency of reduced LVEF.

Key words:Hypertrophic obstructive cardiomyopathy,Left ventricular outflow tract dredging,Electrocardiogram,Left ventricular hypertrophy,Complete left bundle branch block,Left ventricular ejection fraction

CLC Number:

R541

WANG Hongzhen, LIU Xia. Electrocardiographic and echocardiographic characteristics of patients with hypertrophic obstructive cardiomyopathy at one year after left ventricular outflow tract dredging[J]. Journal of Internal Medicine Concepts & Practice, 2025, 20(02): 152-156.

Figures/Tables7

项目	术前	术后1年随访	t	P
心室率（次/min）	64.97±15.62	73.87±11.77	2.517	0.014
PR间期（ms）	157.33±23.31	167.61±25.50	1.723	0.090
QRS间期（ms）	99.22±12.01	138.97±23.23	8.588	0.000
QT间期（ms）	407.58±34.60	415.74±37.82	0.922	0.302
QTc间期（ms）	425.39±33.48	455.16±31.86	3.711	0.000
V5 R波振幅（mV）	2.42±1.14	1.27±0.81	-4.707	0.000
V1 S波振幅（mV）	1.99±0.76	2.45±0.82	2.377	0.020

Table 1

Figure 1

Figure 2

Figure 3

Table 2

Comparison of echocardiography parameters before surgery and 1 year after surgery（n=38，$\bar{x}±s$）

项目	术前	术后1年随访	t	P
AO（mm）	32.84±3.02	32.93±3.38	0.117	0.907
LAD（mm）	45.87±5.08	42.07±4.79	-2.611	0.037
LVEDd（mm）	45.87±5.08	47.53±4.42	1.42	0.160
LVESd（mm）	28.21±3.53	30.40±4.05	2.379	0.020
IVSd（mm）	18.37±3.66	11.70±2.67	-8.37	0.000
LVPWT(mm)	11.10±1.54	9.90±1.12	-3.596	0.001
LVEDV（mL）	96.92±31.27	107.43±23.76	1.525	0.132
LVESV（mL）	31.47±9.90	38.73±10.60	2.911	0.005
LVEF（%）	68.50±4.11	63.87±4.00	-4.666	0.000
LVFS（%）	37.95±4.23	34.67±3.05	-3.547	0.001
SV（mL）	68.08±18.25	68.47±15.38	0.093	0.926

Table 2

Table 3

Comparison of echocardiography parameters before surgery and 1 year after surgery in patients with complete left bundle branch block（n=18，$\bar{x}±s$）

项目	术前	术后1年随访	t	P
AO（mm）	32.83±3.36	32.80±3.32	0.029	0.977
LAD(mm)	43.89±4.08	42.47±4.67	0.933	0.358
LVEDd(mm)	44.83±5.60	49.20±4.84	-2.37	0.024
LVESd(mm)	27.39±3.68	32.13±3.64	-3.705	0.001
IVSd(mm)	18.44±3.29	11.33±2.22	7.109	0.000
LVPWT(mm)	10.94±1.55	9.47±1.06	3.126	0.004
LVEDV(mL)	89.06±36.91	116.80±26.45	-2.434	0.021
LVESV(mL)	29.22±10.24	42.47±11.49	-3.501	0.001
LVEF(%)	69.39±5.29	63.40±4.15	3.595	0.001
LVFS(%)	38.06±5.84	34.40±3.14	2.172	0.038
SV(mL)	65.44±21.20	74.07±17.49	-1.257	0.218

Table 3

Table 4

Comparison of echocardiography parameters before surgery and 1 year after surgery in patients without complete left bundle branch block（n=13，$\bar{x}±s$）

项目	术前	术后1年随访	t	P
AO（mm）	32.62±2.75	32.83±3.01	-0.189	0.852
LAD(mm)	47.08±6.50	41.67±5.65	2.213	0.037
LVEDd(mm)	45.77±4.22	45.58±3.68	0.117	0.908
LVESd(mm)	28.38±3.30	29.00±3.16	-0.475	0.639
IVSd(mm)	17.38±2.99	11.67±2.31	5.321	0.000
LVPWT(mm)	11.54±1.76	10.25±0.96	2.291	0.034
LVEDV(mL)	98.54±21.61	96.75±18.42	0.222	0.826
LVESV(mL)	32.15±9.36	34.00±9.12	-0.499	0.623
LVEF(%)	67.46±2.96	64.83±4.20	1.821	0.082
LVFS(%)	37.69±2.25	35.25±3.31	2.175	0.040
SV(mL)	66.38±12.96	62.42±11.82	0.797	0.433

Table 4

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