Marked Regression of Left Ventricular Hypertrophy after Outflow Desobliteration in HOCM

Figure 1

Upper panel (A–D): HOCM with severe hypertrophy of the left ventricle at baseline, particularly involving the septum ((A) and (C)) and exceeding the “critical” threshold of 30 mm (double arrow in (C)). (A) four-chamber view, (B) cw-Doppler profile of LVOT flow with a resting gradient of 70 mm Hg, (C) short-axis view in diastole with double arrow pointing to anterior septal hypertrophy, (D) apical long axis with the turbulent LVOT jet and the obstruction-associated mitral regurgitation. Lower panel (E–H): two years after successful septal ablation which has left a myectomy-like trough in the basal septum (arrows in (E) and (G)) and completely eliminated outflow gradient (F) and mitral regurgitation (H), regression of left ventricular hypertrophy can be observed both in the septum (double arrows in (G)), and the lateral wall (double arrow in (E)). LA: left atrium RA: right atrium RV: right ventricle LV left ventricle.