{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:57:51Z","timestamp":1791806271758,"version":"4.3.4"},"reference-count":18,"publisher":"IMR Press","issue":"2","license":[{"start":{"date-parts":[[2021,6,30]],"date-time":"2021-06-30T00:00:00Z","timestamp":1625011200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Cardiovasc. Med."],"abstract":"<jats:p>We evaluated the hemodynamic and geometric determinants of latent obstruction (LO, trans-left ventricular outflow tract (LVOT) gradient \u226530 mmHg with provocation) in patients with non-obstructive hypertrophic cardiomyopathy (HCMP). A total of 35 patients with non-obstructive HCMP underwent stepwise supine bicycle exercise echocardiography. Trans-LVOT pressure gradients, mitral geometric parameters, left ventricular ejection fractions (LVEF) and left ventricular end-systolic and diastolic dimensions (LVESD, LVEDD) were measured at each stage. The highest peak LVOT pressure gradient predominantly occurred immediately after exercise (n = 32, 91.3%) rather than during peak exercise (n = 3, 8.7%). Significant LO developed in nine patients (25%). No significant differences were found in resting echocardiographic parameters. Compared to the remaining patients, however, patients with LO had longer residual mitral leaflets (defined as residual portions of leaflets after coaptation; 4 \u00b1 4 vs. 13 \u00b1 4 mm, respectively; p = 0.001) and higher resting LVOT pressure gradients (7.4 \u00b1 3.7 vs. 12.9 \u00b1 5.8 mmHg, respectively; p = 0.001). Substantial decreases in mitral annular diameters from peak exercise to recovery after exercise were observed in the LO group, while mitral annular diameters increased after exercise in the non-LO group. In conclusion, the highest peak LVOT pressure gradient predominantly occurred immediately after exercise rather than during peak exercise, regardless of LO. Abrupt decrease of mitral annular diameter immediately after exercise, a longer residual mitral leaflet and a higher resting LVOT pressure gradient at rest might be related to LO.<\/jats:p>","DOI":"10.31083\/j.rcm2202053","type":"journal-article","created":{"date-parts":[[2021,7,5]],"date-time":"2021-07-05T05:11:38Z","timestamp":1625461898000},"source":"Crossref","is-referenced-by-count":5,"title":["Left ventricular outflow obstruction occurs immediately after exercise in patients with non-obstructive hypertrophic cardiomyopathy"],"prefix":"10.31083","volume":"22","author":[{"given":"Jong-Youn","family":"Kim","sequence":"first","affiliation":[{"name":"Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 06273 Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eui-Young","family":"Choi","sequence":"first","affiliation":[{"name":"Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 06273 Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wonho","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Cardiology, Eulji University Hospital, Eulji University School of Medicine, 35233 Daejeon, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Se-Joong","family":"Rim","sequence":"first","affiliation":[{"name":"Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 06273 Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2021,6,30]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Maron MS, Olivotto I, Zenovich AG, Link MS, Pandian NG, Kuvin JT, et al. 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