Author + information
- Lee Moschler Pierson,
- Ahmad Masri,
- Nicholas Smedira,
- Bruce Lytle,
- Peyman Naji,
- Maran Thamilarasan,
- Harry Lever,
- Leslie Cho and
- Milind Desai
Hypertrophic cardiomyopathy (HCM) patients have functional capacity impairment, which is due to left ventricular outflow tract (LVOT) obstruction, mitral regurgitation (MR) and LV dysfunction. Cardiopulmonary stress testing with echocardiography is used for symptom evaluation in HCM patients. We sought to identify predictors of peak oxygen consumption (VO2) in such patients.
We studied 1,017 HCM patients (63% male, 50±14 years) who underwent combined cardiopulmonary and stress echocardiography. Clinical, echocardiographic (LV thickness, resting and post–exercise LVOT gradient, diastolic function and MR) and cardiopulmonary stress [peak VO2 and respiratory exchange ratio (RER)] variables were recorded.
Resting LV ejection fraction, post exercise LVOT gradient and maximal LV thickness were 62±6%, 92±51 mm Hg and 2.1±0.5 cm, respectively. Peak VO2 and RER were 21±6 ml/kg/min and 1.1±0.7, respectively. Univariate and stepwise multivariate regression analysis, evaluating for the predictors of peak VO2 are shown in figure.
In a large group of HCM patients undergoing cardiopulmonary and stress echocardiography, clinical parameters like age, gender, body mass index, hypertension, atrial fibrillation and pacemaker predict peak VO2. On echo, LV thickness, ejection fraction and LV dimension, not LVOT gradient, diastolic function or MR, predict exercise capacity.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.–10:30 a.m.
Session Title: Sports and Exercise Cardiology: Exercise Tolerance in HCM
Abstract Category: 29. Sports and Exercise Cardiology: Diagnostic Testing: ECG Exercise or “The Older Athlete”
Presentation Number: 1217–257
- 2013 American College of Cardiology Foundation