{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:47Z","timestamp":1753876247617,"version":"3.41.2"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T00:00:00Z","timestamp":1658707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,4]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Beta-blockers and Class 1A antiarrhythmics decrease the subaortic pressure gradient in hypertrophic obstructive cardiomyopathy. However, real-time monitoring of the pressure gradient transition during intravenous therapy, based on cardiac catheterization, has never been reported.<\/jats:p>\n <\/jats:sec>\n \n Case summary<\/jats:title>\n A 52-year-old man, with an history of hypertension, was transferred to our hospital, complaining of angina. A 12-lead electrocardiogram showed diffuse ST-segment depression, and transthoracic echocardiography revealed a thickened left ventricular outflow tract (LVOT) septum, resulting in LVOT obstruction which had never been diagnosed. Besides, severe mitral regurgitation (MR) due to systolic anterior motion was detected. Emergent cardiac catheterization revealed normal coronary arteries and severe MR. Simultaneous pressure measurements were taken at the ascending aorta (using a coronary catheter) and left ventricle (using a pressure wire). The subaortic systolic pressure gradient was 147\u2005mmHg: 251\u2005mmHg in the left ventricle and 104\u2005mmHg in the aorta. Intravenous cibenzoline, following propranolol, was administered to ameliorate the pressure gradient, following which his chest pain disappeared immediately; the pressure gradient decreased to 13\u2005mmHg. Further, severe MR was diminished. Oral bisoprolol and cibenzoline administration effectively stabilized his condition after catheterization.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Monitoring the simultaneous pressure between the left ventricle and aorta with a pressure wire revealed drastic improvement in the subaortic systolic pressure gradient. Owing to the soft, fine structure, the pressure wire allowed recording of the subaortic pressure gradient stably with less frequent premature ventricular contractions. Furthermore, this method could decrease the burden of catheter-related complications by eliminating the need for multiple atrial punctures.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytac311","type":"journal-article","created":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T18:29:18Z","timestamp":1658773758000},"source":"Crossref","is-referenced-by-count":1,"title":["Dynamic improvement of an acute exacerbated subaortic pressure gradient after intravenous propranolol and cibenzoline, recorded using a pressure wire: a case report"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6724-3782","authenticated-orcid":false,"given":"Yoshihiro","family":"Harano","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Gifu Heart Centre , 4-14-4 Yabutaminami, Gifu 500-8384 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiaki","family":"Kawase","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Gifu Heart Centre , 4-14-4 Yabutaminami, Gifu 500-8384 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hitoshi","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Gifu Heart Centre , 4-14-4 Yabutaminami, Gifu 500-8384 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,7,25]]},"reference":[{"key":"2022080416231796000_ytac311-B1","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.jchf.2017.09.011","article-title":"Clinical Spectrum and management of heart failure in hypertrophic cardiomyopathy","volume":"6","author":"Maron","year":"2018","journal-title":"JACC Heart Fail"},{"key":"2022080416231796000_ytac311-B2","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1056\/NEJM199609263351305","article-title":"The effect of the ingestion of ethanol on obstruction of the left ventricular outflow tract in hypertrophic cardiomyopathy","volume":"335","author":"Paz","year":"1996","journal-title":"N Engl J Med"},{"key":"2022080416231796000_ytac311-B3","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1161\/CIRCHEARTFAILURE.112.000122","article-title":"Treatment of obstructive hypertrophic cardiomyopathy symptoms and gradient resistant to first-line therapy with \u03b2-blockade or verapamil","volume":"6","author":"Sherrid","year":"2013","journal-title":"Circ Heart Fail"},{"key":"2022080416231796000_ytac311-B4","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1016\/j.jacc.2005.01.012","article-title":"Multicenter study of the efficacy and safety of disopyramide in obstructive hypertrophic cardiomyopathy","volume":"45","author":"Sherrid","year":"2005","journal-title":"J Am Coll Cardiol"},{"key":"2022080416231796000_ytac311-B5","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1177\/000331979905000410","article-title":"Effect of disopyramide on left ventricular pressure gradient in hypertrophic obstructive cardiomyopathy in comparison with propranolol\u2013a case report","volume":"50","author":"Tokudome","year":"1999","journal-title":"Angiology"},{"key":"2022080416231796000_ytac311-B6","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s12872-016-0457-2","article-title":"Transradial versus transfemoral approach for coronary angiography and angioplasty\u2014A prospective, randomized comparison","volume":"17","author":"Bhat","year":"2017","journal-title":"BMC Cardiovasc Disord"}],"container-title":["European Heart Journal - 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