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      Changes of the Degree of Hypertrophy in Hypertrophic Obstructive Cardiomyopathy under Medical and Surgical Treatment

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          Abstract

          The aim of our study was to establish the extent to which therapy of hypertrophic obstructive cardiomyopathy (HOCM) can influence the degree of hypertrophy. By means of two-dimensionally guided M-mode echocardiography, 120 patients with HOCM (age range 4–72 years, mean age 41 years) were observed over an average period of 49 ± 41 months. Depending on the respective therapy, we formed four patient groups: group 1:13 patients without any therapy (follow-up period 31 ± 30 months); group 2: 27 patients receiving propranolol (follow-up period 47 ± 34 months); group 3: 50 patients receiving verapamil (follow-up period 39 ± 27 months), and group 4: 30 patients with myectomy (follow-up period 34 ± 32 months). In group 4, as expected, the thickness of the interventricular septum (IVS) decreased postoperatively (from 24.2 ± 4.5 to 19.8 ± 6.7 mm, p < 0.05), and the left ventricular posterior wall (LVPW) thickness also decreased later postoperatively (from 13.0 ± 2.6 to 11.9 ± 2.3 mm, p < 0.05). The left ventricular diameters increased. In groups 2 and 3 treated with pharmacotherapy as in the untreated patients of group 1 on average there was no change in IVS and LVPW thickness nor in the left ventricular diameters (with the exception of increasing left ventricular end-diastolic diameter in the propranolol-treated group). In contrast to group 1 in occasional cases there were substantial decreases of IVS thickness (11% of the patients in group 2, 13 % in group 3) or LVPW thickness (13% of the patients in group 2, 12% in group 3). However, the thickness remained mainly unchanged (IVS: 74% of the patients in group 2, 71% in group 3; LVPW: 67% in group 2, 70% in group 3) or increased (IVS: 15% in group 2, 17% in group 3; LVPW: 21 % in group 2, 19% in group 3). The differences between groups 2 and 3 were not significant. Thus, our investigations indicated that on average neither propranolol nor verapamil leads to a regression of hypertrophy in HOCM.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1989
          1989
          12 November 2008
          : 76
          : 4
          : 255-263
          Affiliations
          aMedizinische Klinik III, Universität Köln; bAbteilung für Kardiologie, Medizinische Einrichtungen der Universität Düsseldorf; cAbteilung für Medizinische Informatik und Biomathematik, Ruhruniversität Bochum, BRD
          Article
          174501 Cardiology 1989;76:255–263
          10.1159/000174501
          2529965
          © 1989 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 9
          Categories
          Original Paper

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