Document Detail

Exercise Response in Hypertrophic Cardiomyopathy: Blunted Left Ventricular Deformational and Twisting Reserve with Altered Systolic-Diastolic Coupling.
MedLine Citation:
PMID:  22414888     Owner:  NLM     Status:  Publisher    
BACKGROUND: -Abnormal left ventricular (LV) deformational mechanics have been demonstrated in patients with hypertrophic cardiomyopathy (HCM) at rest, but there is a lack of information on their adaptation to exercise. The aim of this study was to assess the adaptability of LV strains and torsional mechanics during exercise in HCM patients. METHODS AND RESULTS: -Twenty non obstructive HCM patients (48.3±12.3 years; 14 men) and 20 controls underwent speckle tracking echocardiographic measurement of longitudinal, radial and circumferential strains, systolic twist and diastolic untwisting rate (UTR) at rest and submaximal exercise. HCM patients showed lower resting longitudinal (-15.7±5.0 vs. -19.4±2.6%, p<0.001) and radial (38.1±11.3 vs. 44.7±14.4%, p<0.05) strains, but higher circumferential strain (-21.9±4.0 vs. -18.8±2.3%, p<0.05) and twist (15.7±3.6 vs. 9.3±2.6°, p<0.0001) than controls. Exercise induced an increase in all strains in controls, but only a moderate increase in longitudinal strain (to -18.4±5.0%), without significant changes in radial and circumferential strains or twist in HCM patients. Exercise peak UTR was lower (-119.0±31.5 vs. -137.3±41.1°/s) and occurred later (137±18 vs. 125±11% systolic time, p<0.05) in HCM than in controls. A significant relationship between twist and UTR was obtained in controls (β =-0.0807, p<0.001) but not in HCM patients (β =-0.0051, p=0.68). CONCLUSIONS: -HCM patients had severely limited strain adaptability and no LV twisting reserve at exercise. They had reduced and delayed UTR with reduced systolic-diastolic coupling efficiency by twist-untwist mechanics.
Camille Soullier; Philippe Obert; Gregory Doucende; Stéphane Nottin; Stéphane Cade; Antonia Perez Martin; Patrick Messner-Pellenc; Iris Schuster
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-13
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  -     ISSN:  1942-0080     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1 Nimes University Hospital, Nîmes, France;
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