Abstract

We read with great interest the comments by Dimitrow et al. on our paper ‘Comparison of Valsalva manoeuvre and exercise in echocardiographic evaluation of left ventricular outflow tract obstruction in hypertrophic cardiomyopathy’1 and are thankful for their interest in our study. Dimitrow et al. 2–5 have contributed considerably to our understanding of the haemodynamic changes responsible for the development of left ventricular outflow gradient. Dimitrow et al. addressed the question whether or not it is possible to perform exercise treadmill testing in a semi-supine position with a left lateral tilt. This positioning of patients has been used in several studies in our institution,1,6–8 …

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