Document Detail


Exercise eco-Doppler in hypertrophic cardiomyopathy patients. Determinant factors of exercise intolerance.
MedLine Citation:
PMID:  22959177     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION AND OBJECTIVES: At-rest echocardiography is a poor predictor of exercise capacity in patients with hypertrophic cardiomyopathy. We aimed to test the performance of treadmill exercise Doppler echocardiography in the prediction of functional limitations in these patients.
METHODS: Eighty-seven consecutive patients with hypertrophic cardiomyopathy underwent treadmill exercise echocardiography with direct measurement of oxygen consumption. Both at rest and at peak exercise, the mitral inflow, mitral regurgitation, left ventricular outflow tract obstruction and mitral annulus velocities were assessed.
RESULTS: Forty-three patients developed left ventricular outflow tract obstruction during exercise, which significantly decreased oxygen consumption (21.3 [5.7] mL/kg/min vs 24.6 [6.1] mL/kg/min; P=.012), and had greater left atrial volume (42.1 [14.5] mL/m(2) vs 31.1 [11.6] mL/m(2); P<.001) and a higher degree of mitral regurgitation and E/E' ratio during exercise. Exercise variables improved the predictive value of functional capacity (adjusted R(2) rose from 0.38 to 0.49). Independent predictors of oxygen consumption were age, left atrial volume, E/E' ratio and the presence of left ventricular outflow tract obstruction. In a subset of patients without left ventricular outflow obstruction, only left ventricular and atrial volume indexes were independent predictors of exercise capacity.
CONCLUSIONS: In patients with hypertrophic cardiomyopathy, left ventricular outflow tract obstruction and left atrial volume are the main predictors of exercise capacity. Exercise echocardiography is a better predictor of functional performance than at-rest echocardiography, although its predictive power is under 50%. In nonobstructed patients, left atrial and ventricular volumes were the independent factors. Full English text available from:www.revespcardiol.org/en.
Authors:
Gonzalo de la Morena; Cesar Caro; Daniel Saura; Francisco Marín; Juan R Gimeno; Josefa González; María José Oliva; Miguel García-Navarro; Angel López-Cuenca; María D Espinosa; Mariano Valdés
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Publication Detail:
Type:  Journal Article     Date:  2012-09-05
Journal Detail:
Title:  Revista española de cardiología (English ed.)     Volume:  66     ISSN:  1885-5857     ISO Abbreviation:  Rev Esp Cardiol (Engl Ed)     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-28     Completed Date:  2013-07-25     Revised Date:  2014-09-16    
Medline Journal Info:
Nlm Unique ID:  101587954     Medline TA:  Rev Esp Cardiol (Engl Ed)     Country:  Spain    
Other Details:
Languages:  eng; spa     Pagination:  98-103     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.
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