{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T01:43:58Z","timestamp":1790905438400,"version":"4.1.0"},"reference-count":38,"publisher":"BMJ","issue":"21","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Heart"],"published-print":{"date-parts":[[2009,11,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background:<\/jats:title>\n                  <jats:p>Patients with hypertrophic cardiomyopathy (HCM) exhibit a difference in left ventricular outflow tract (LVOT) obstruction, independently of basal septal thickness (BST). Some patients with HCM have a steeper left ventricle to aortic root angle than controls.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>To test the predictors of the LV-aortic root angle and the association between LV-aortic root angle and LVOT obstruction using three-dimensional imaging.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients:<\/jats:title>\n                  <jats:p>153 consecutive patients with HCM (mean (SD) age 46 (14) years, 68% men) and 62 patients with hypertensive heart disease of the elderly (all &gt;65 years of age, 73 (6) years, 34% men) who underwent whole-heart three-dimensional cardiac magnetic resonance (CMR) angiography (1.5 T) and Doppler echocardiography. Forty-two controls (age 43 (11) years, 38% men) who underwent contrast-enhanced multidetector computed tomography and were free of cardiovascular pathology were also studied.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcomes:<\/jats:title>\n                  <jats:p>LV-aortic root angle, BST and maximal non-exercise LVOT gradient were measured in patients with HCM and in hypertensive-elderly patients. Additionally, LV-aortic root angle and BST were measured in controls.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>The mean (SD) LV-aortic root angle was significantly different (p&lt;0.001) in the three groups: HCM (134 (10)\u00b0), hypertensive-elderly (128 (10)\u00b0), control (140 (7)\u00b0). There was an inverse correlation between age and LV-aortic root angle in the three groups (all p&lt;0.001): HCM (r\u200a=\u200a\u22120.56), hypertensive-elderly (r\u200a=\u200a\u22120.35), control (r\u200a=\u200a\u22120.48). On univariate analysis, in the HCM group, LV-aortic root angle (\u03b2\u200a=\u200a\u22120.34, p&lt;0.001), age (\u03b2\u200a=\u200a0.23, p\u200a=\u200a0.01) and end-systolic volume index (\u03b2\u200a=\u200a\u22120.20, p\u200a=\u200a0.02), but not BST (\u03b2\u200a=\u200a0.02, p\u200a=\u200a0.8), were associated with LVOT gradient. On multivariate analysis, only LV-aortic root angle was associated with LVOT gradient.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions:<\/jats:title>\n                  <jats:p>Patients with HCM have a steeper LV-aortic root angle than controls. In patients with HCM, a steeper LV-aortic root angle predicts dynamic LVOT obstruction, independently of BST.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/hrt.2009.166777","type":"journal-article","created":{"date-parts":[[2009,6,23]],"date-time":"2009-06-23T21:07:57Z","timestamp":1245791277000},"page":"1784-1791","source":"Crossref","is-referenced-by-count":69,"title":["Steep left ventricle to aortic root angle and hypertrophic obstructive cardiomyopathy: study of a novel association using three-dimensional multimodality imaging"],"prefix":"10.1136","volume":"95","author":[{"given":"D H","family":"Kwon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N G","family":"Smedira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z B","family":"Popovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B 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