CardiomyopathyUtility of cardiopulmonary exercise in the assessment of clinical determinants of functional capacity in hypertrophic cardiomyopathy☆
Section snippets
Patient characteristics
Between January 1997 and March 1998, 135 consecutive patients with HC underwent cardiopulmonary exercise testing. Clinical characteristics of the patients are listed in Table I. The diagnosis of HC was based on the conventional World Health Organization definition6 in 109 patients (81%). The remaining patients fulfilled recently proposed criteria for HC within the context of familial disease or were proved gene carriers.7, 8
Controls
Fifty healthy age- and sex-matched sedentary volunteers with normal
Echocardiography
The results of left ventricular wall thickness measurements, patterns of left ventricular hypertrophy, mean Wigle score, and left ventricular inflow and outflow velocities are presented in Table I. The mean E-wave velocity was 0.7 ± 0.2 m/s (range 0.2 to 1.8). The mean A-wave velocity was 0.6 ± 0.3 m/s (range 0.2 to 1.4). The mean E/A ratio was 1.5 ± 0.8 (range 0.4 to 6.0). Twenty-one patients (16%) had an E/A ratio of <1.
Exercise
All exercise tests were completed without adverse complications. One
Cardiopulmonary parameters in relation to symptoms
This study demonstrated that the peak VO2 was low in almost all patients with HC irrespective of symptomatic status, magnitude of left ventricular wall thickness, presence or absence of a left ventricular outflow gradient, or exercise-related heart rate and blood pressure responses. Patients in New York Heart Association class I had higher cardiopulmonary indexes (except ΔVE/ΔVCO2) than those in classes II and III, but there was considerable variation in the distribution of these indexes in
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Left Atrial Myopathy is Associated With Exercise Incapacity and Ventilatory Inefficiency in Hypertrophic Cardiomyopathy
2023, Heart Lung and CirculationCitation Excerpt :Exercise intolerance and impaired ventilatory efficiency are multifactorial in HCM. The most important factor leading to both is LV diastolic dysfunction, which leads to failure of stroke volume to adequately augment during exercise, leading to a ventilation-perfusion mismatch, which results in exercise limitation of HCM patients [19,20]. This association has been confirmed by both invasive and non-invasive studies [21,22]: Critoph et al. subjected 70 HCM patients and 28 healthy volunteers to CPET and non-invasive haemodynamic assessment using finger plethysmography, demonstrating that cardiac reserve is impaired in HCM due to failure of stroke volume augmentation, and LVOT obstruction exacerbates this abnormal response [21].
Hypertrophic cardiomyopathy
2020, IJC Heart and VasculatureExercise testing: New guidelines
2019, Presse MedicaleInfluence of centre expertise on the diagnosis and management of hypertrophic cardiomyopathy: A study from the French register of hypertrophic cardiomyopathy (REMY)
2019, International Journal of Cardiology
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Dr. Sharma is supported by a fellowship grant from the British Heart Foundation, London, United Kingdom.