Most patients with hypertrophic cardiomyopathy (HCM) usually complain of a reduced exercise capacity, and several factors have been advocated as possible causes of this clinical feature. The present single-center study was designed to investigate exercise capacity and its main clinical determinants in HCM patients. One hundred ninety seven patients of 223 evaluated underwent a complete clinical assessment, including Doppler echocardiography, cardiopulmonary exercise test (CPET) and, in most cases, cardiac magnetic resonance. The HCM population (male 75 %; age 47 ± 16 years; NYHA class I or II 95 %; left ventricular ejection fraction 61 ± 3 %; resting left ventricular outflow tract gradient ≥30 mmHg 22 %; late gadolinium enhancement presence 58 %) showed slightly reduced mean peak oxygen uptake values (pVO2 75 ± 15 %, 23.2 ± 6.7 ml/kg/min) with a significant reduction of the achieved percentage of peak heart rate reserve (%pHRR 65 ± 20 %). Adopting a pVO2 <80 % cut-off value, 59 % of HCM patients showed a reduced exercise capacity. Age, male gender, left atrial size, chronotropic and systolic blood pressure response, ventilatory efficiency, late gadolinium enhancement presence and β-blocker therapy were independently associated with pVO2 (R 2-adjusted index 0.738). A %pHRR cut-off value of 74 % appeared to most accurately predict an impaired exercise capacity (area under curve 0.90). A great prevalence of reduced exercise capacity is present in NYHA class I-II HCM patients. Notwithstanding its multifactorial genesis, few parameters might be adopted in identifying this feature. In this context, %pHRR value might represent a reliable and easy-to-obtain tool for the clinical evaluation of HCM patients.

Magrì, D., Agostoni, P., Cauti, F., Musumeci, B., Egidy Assenza, G., De Cecco, C., et al. (2014). Determinants of peak oxygen uptake in patients with hypertrophic cardiomyopathy: a single-center study. INTERNAL AND EMERGENCY MEDICINE, 9(3), 293-302 [10.1007/s11739-012-0866-x].

Determinants of peak oxygen uptake in patients with hypertrophic cardiomyopathy: a single-center study

Muscogiuri G;
2014

Abstract

Most patients with hypertrophic cardiomyopathy (HCM) usually complain of a reduced exercise capacity, and several factors have been advocated as possible causes of this clinical feature. The present single-center study was designed to investigate exercise capacity and its main clinical determinants in HCM patients. One hundred ninety seven patients of 223 evaluated underwent a complete clinical assessment, including Doppler echocardiography, cardiopulmonary exercise test (CPET) and, in most cases, cardiac magnetic resonance. The HCM population (male 75 %; age 47 ± 16 years; NYHA class I or II 95 %; left ventricular ejection fraction 61 ± 3 %; resting left ventricular outflow tract gradient ≥30 mmHg 22 %; late gadolinium enhancement presence 58 %) showed slightly reduced mean peak oxygen uptake values (pVO2 75 ± 15 %, 23.2 ± 6.7 ml/kg/min) with a significant reduction of the achieved percentage of peak heart rate reserve (%pHRR 65 ± 20 %). Adopting a pVO2 <80 % cut-off value, 59 % of HCM patients showed a reduced exercise capacity. Age, male gender, left atrial size, chronotropic and systolic blood pressure response, ventilatory efficiency, late gadolinium enhancement presence and β-blocker therapy were independently associated with pVO2 (R 2-adjusted index 0.738). A %pHRR cut-off value of 74 % appeared to most accurately predict an impaired exercise capacity (area under curve 0.90). A great prevalence of reduced exercise capacity is present in NYHA class I-II HCM patients. Notwithstanding its multifactorial genesis, few parameters might be adopted in identifying this feature. In this context, %pHRR value might represent a reliable and easy-to-obtain tool for the clinical evaluation of HCM patients.
Articolo in rivista - Articolo scientifico
Cardiopulmonary exercise test; Chronotropic incompetence; Hypertrophyc cardiomyopathy;
English
293
302
10
Magrì, D., Agostoni, P., Cauti, F., Musumeci, B., Egidy Assenza, G., De Cecco, C., et al. (2014). Determinants of peak oxygen uptake in patients with hypertrophic cardiomyopathy: a single-center study. INTERNAL AND EMERGENCY MEDICINE, 9(3), 293-302 [10.1007/s11739-012-0866-x].
Magrì, D; Agostoni, P; Cauti, F; Musumeci, B; Egidy Assenza, G; De Cecco, C; Muscogiuri, G; Maruotti, A; Ricotta, A; Pagannone, E; Marino, L; Santini, D; Proietti, G; Serdoz, A; Paneni, F; Volpe, M; Autore, C
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/378635
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