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The importance of left ventricular outflow tract and mid-ventricular gradients in stress echocardiography: a narrative review

datacite.subject.sdg03:Saúde de Qualidade
datacite.subject.sdg04:Educação de Qualidade
datacite.subject.sdg09:Indústria, Inovação e Infraestruturas
dc.contributor.authorCotrim, Carlos
dc.contributor.authorPalinkas, Eszter Dalma
dc.contributor.authorCotrim, Nuno
dc.date.accessioned2026-02-26T13:02:39Z
dc.date.available2026-02-26T13:02:39Z
dc.date.issued2023-08-14
dc.description.abstractThis review aims to serve as a guide for clinical practice and to appraise the current knowledge on exercise stress echocardiography in the evaluation of intraventricular obstruction in HCM, in patients with cardiac syndrome X, in athletes with symptoms related to exercise, and in patients with normal left ventricular systolic function and exercise-related unexplained tiredness. The appearance of intraventricular obstruction while exercising is considered rare, and it usually occurs in patients with hypertrophy of the left ventricle. The occurrence of intraventricular obstruction when exercising has been evidenced in patients with hypertrophic cardiomyopathy, athletes, patients with cardiac syndrome X, patients with syncope or dizziness related to exercise, and patients with dyspnea and preserved ejection fraction. The clinical significance of this observation and the exercise modality that is most likely to trigger intraventricular obstruction remains unknown. Supine exercise and lying supine after exercise are less technically demanding, but they are also less physiologically demanding than upright exercise. Importantly, in everyday life, human beings generally do not become supine after exercise, as takes place in post-exercise treadmill stress echocardiograms in most echocardiography labs. The presence of induced intraventricular obstruction might be considered when patients have exercise-related symptoms that are not understood, and to assess prognosis in hypertrophic cardiomyopathy.eng
dc.identifier.doi10.3390/jcm12165292
dc.identifier.issn2077-0383
dc.identifier.urihttp://hdl.handle.net/10400.1/28266
dc.language.isoeng
dc.peerreviewedyes
dc.publisherMDPI
dc.relation.ispartofJournal of Clinical Medicine
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectIntraventricular gradients
dc.subjectExercise echocardiography
dc.subjectAngina
dc.subjectAthletes
dc.subjectHypertrophic cardiomyopathy
dc.subjectTiredness with normal systolic function
dc.subjectSyncope or dizziness related to exercise
dc.titleThe importance of left ventricular outflow tract and mid-ventricular gradients in stress echocardiography: a narrative revieweng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue16
oaire.citation.startPage5092
oaire.citation.titleJournal of Clinical Medicine
oaire.citation.volume12
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameCotrim
person.givenNameCarlos
person.identifier.ciencia-id1B11-CED8-69A1
person.identifier.orcid0000-0002-4802-0831
relation.isAuthorOfPublicationdef25fde-92b5-4f4f-a790-f1ae043f8519
relation.isAuthorOfPublication.latestForDiscoverydef25fde-92b5-4f4f-a790-f1ae043f8519

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