Association of LVOT Gradient and LA Strain with Cardiac Events in Pediatric HCM
By
Addison Gearhart
Sonia F. Epstein
Kimberlee Gauvreau
Alessandra Ferraro
Christina M. Mangano
Ingrid Roth
David Harrild
Steven D. Colan
Ming Hui Chen
June 18, 2026
Clinical Scorecard: Relationship Between LVOT Gradient, LA Strain, and Cardiac Events in Children with HCM
At a Glance
Category Detail
Condition Hypertrophic Cardiomyopathy (HCM) Key Mechanisms LVOT obstruction and left atrial strain Target Population Children with HCM (≤ 21 years) Care Setting Single-center study at Boston Children’s Hospital
Key Highlights
LVOT gradients ≥ 30 mm Hg indicate obstruction. LA strain is a novel predictor of adverse cardiac events. Study included both sarcomeric and nonsarcomeric HCM patients. Composite cardiac endpoint includes heart failure, syncope, and arrhythmias. ESE was performed to assess LVOT gradients and LA function. Guideline-Based Recommendations
Diagnosis
Use exercise stress echocardiography (ESE) to assess LVOT gradients. Management
Monitor LA strain and LVOT gradients in pediatric HCM patients. Monitoring & Follow-up
Assess for cardiac events post-ESE using a composite endpoint. Risks
Increased LV filling pressures due to LVOT obstruction. Patient & Prescribing Data
Children diagnosed with HCM at Boston Children's Hospital.
Standardized clinical assessment and management protocol for HCM.
Clinical Best Practices
Perform ESE to evaluate exercise-induced LVOT gradients. Utilize LA strain analysis for risk stratification in HCM. Follow ASE standards for LA imaging and strain assessment. Related Resources & Content
