ID 109593
Author
Hara, Tomoya Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School
Kishi-Tanaka, Kumiko Department of Gastroenterology and Oncology, Institute of Health Biosciences, the University of Tokushima Graduate School
Iwase, Takashi Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School KAKEN Search Researchers
Yamada, Hirotsugu Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Akaike, Masashi Department of Medical Education, Institute of Health Biosciences, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Sata, Masataka Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Keywords
diastolic heart failure
lower limb positive pressure test
apical hypertrophic cardiomyopathy
Content Type
Journal Article
Description
A 70-year-old woman with dyspnea on exertion was admitted to our hospital. She had a history of apical hypertrophic cardiomyopathy (HCM) and repeated hospitalization for heart failure. Results of physical examination were normal except for leg edema. Echocardiography showed apical HCM with preserved LV systolic function (LVEF=70%). Although dyspnea on exertion and leg edema improved rapidly with the use of diuretics, her symptoms soon worsened when daily activity was started again. In order to examine the effect of preload on hemodynamics, we performed a lower limb positive pressure test by compressing both legs using a household air leg massager. Echocardiography showed increases in mitral E velocity, E/A ratio and pulmonary venous D flow as well as decrease in stroke volume during the lower limb positive pressure test. Simultaneously-recorded pressure study also showed elevated LVEDP and increased v wave of pulmonary capillary wedge pressure. These results suggested that even a small increase in preload led to elevation of LVEDP and symptomatic worsening due to severe diastolic heart failure in the present case. The lower limb positive pressure test may be useful for assessing the effect of preload on hemodynamics in patients with diastolic heart failure.
Journal Title
The journal of medical investigation : JMI
ISSN
13431420
NCID
AA11166929
Publisher
The University of Tokushima Faculty of Medicine
Volume
61
Issue
3-4
Start Page
404
End Page
408
Sort Key
404
Published Date
2014-08
EDB ID
FullText File
language
eng
TextVersion
Publisher
departments
University Hospital
Medical Sciences