Document Detail

Aortic stiffness independently predicts exercise capacity in hypertrophic cardiomyopathy: a multimodality imaging study.
MedLine Citation:
PMID:  20659950     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Exercise capacity in patients with hypertrophic cardiomyopathy (HCM) varies despite similar diastolic dysfunction, left ventricular outflow tract (LVOT) obstruction and mitral regurgitation (MR). Pulse wave velocity (PWV), determined by cardiac magnetic resonance (CMR), measures aortic stiffness and is abnormal in patients with HCM in comparison with controls. OBJECTIVE: To determine potential clinical and imaging predictors of peak oxygen consumption (pVO(2)) in patients with HCM. METHODS: Fifty newly referred patients with HCM (62% men, 44+/-13 years, 90% receiving optimal drugs, 18% hypertensive) underwent Doppler echocardiography (transthoracic echocardiography (TTE)), cardiopulmonary exercise testing and CMR for symptom evaluation. TTE variables (diastology, post exercise MR and LVOT gradient (mmHg)), pVO(2) (ml/kg/min) and CMR variables (PWV (aortic path length between mid- and descending aorta/time delay between arrival of the foot of the pulse wave between two points, m/s), and LV volumetric indices) were measured. RESULTS: After exercise LVOT gradient, MR, deceleration time and pVO(2) were 104+/-52, 1+/-1, 240+/-79 ms, and 25+/-6, respectively. Mean basal septal thickness (cm), PWV, EF, ESV index (ml/m(2)), EDV index (ml/m(2)) and LV mass index (g/m(2)) were 1.9+/-0.5, 9.3+/-7, 64%+/-7, 32+/-9, 87+/-17 and 112+36, respectively. Multiple regression analyses showed that only age (beta=-0.38, p=0.004) and PWV (beta=-0.33, p=0.01) predicted pVO(2). CONCLUSION: In patients with HCM, age and PWV are predictors of pVO(2), independent of LV thickness, LVOT gradient and diastolic indices. Aortic stiffness potentially has a role in evaluation of symptoms of patients with HCM.
Bethany A Austin; Zoran B Popovic; Deborah H Kwon; Maran Thamilarasan; Thananya Boonyasirinant; Scott D Flamm; Harry M Lever; Milind Y Desai
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  96     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-27     Completed Date:  2010-08-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1303-10     Citation Subset:  AIM; IM    
Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
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MeSH Terms
Aorta / physiopathology*,  ultrasonography
Cardiomyopathy, Hypertrophic / pathology,  physiopathology*,  ultrasonography
Echocardiography, Stress / methods
Exercise Test / methods
Exercise Tolerance / physiology*
Magnetic Resonance Imaging / methods
Middle Aged
Oxygen Consumption / physiology

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