Invasive Cardiac Hemodynamics in Apical Hypertrophic Cardiomyopathy.

Autor: Malik AA; Mayo Clinic, Department of Cardiovascular Medicine Jacksonville FL USA., Saraswati U; Mayo Clinic, Department of Cardiovascular Medicine Rochester MN USA., Miranda WR; Mayo Clinic, Department of Cardiovascular Medicine Rochester MN USA., Covington M; Mayo Clinic, Department of Cardiovascular Medicine Rochester MN USA., Scott CG; Mayo Clinic, Department of Cardiovascular Medicine Rochester MN USA., Lee AT; Mayo Clinic, Department of Quantitative Health Sciences Rochester MN USA., Arruda-Olson A; Mayo Clinic, Department of Cardiovascular Medicine Rochester MN USA., Geske JB; Mayo Clinic, Department of Cardiovascular Medicine Rochester MN USA., Klarich KW; Mayo Clinic, Department of Cardiovascular Medicine Rochester MN USA., Anand V; Mayo Clinic, Department of Cardiovascular Medicine Rochester MN USA.
Jazyk: angličtina
Zdroj: Journal of the American Heart Association [J Am Heart Assoc] 2024 May 07; Vol. 13 (9), pp. e032520. Date of Electronic Publication: 2024 Apr 30.
DOI: 10.1161/JAHA.123.032520
Abstrakt: Background: Symptomatic limitations in apical hypertrophic cardiomyopathy may occur because of diastolic dysfunction with resultant elevated left ventricular filling pressures, cardiac output limitation to exercise, pulmonary hypertension (PH), valvular abnormalities, and/or arrhythmias. In this study, the authors aimed to describe invasive cardiac hemodynamics in a cohort of patients with apical hypertrophic cardiomyopathy.
Methods and Results: Patients presenting to a comprehensive hypertrophic cardiomyopathy center with apical hypertrophic cardiomyopathy were identified (n=542) and those who underwent invasive hemodynamic catheterization (n=47) were included in the study. Of these, 10 were excluded due to postmyectomy status or incomplete hemodynamic data. The mean age was 56±18 years, 16 (43%) were women, and ejection fraction was preserved (≥50%) in 32 (91%) patients. The most common indication for catheterization was dyspnea (48%) followed by suspected PH (13%), and preheart transplant evaluation (10%). Elevated left ventricular filling pressures at rest or exercise were present in 32 (86%) patients. PH was present in 30 (81%) patients, with 6 (20%) also having right-sided heart failure. Cardiac index was available in 25 (86%) patients with elevated resting filling pressures. Of these, 19 (76%) had reduced cardiac index and all 6 with right-sided heart failure had reduced cardiac index. Resting hemodynamics were normal in 8 of 37 (22%) patients, with 5 during exercise; 3 of 5 (60%) patients had exercise-induced elevation in left ventricular filling pressures.
Conclusions: In patients with apical hypertrophic cardiomyopathy undergoing invasive hemodynamic cardiac catheterization, 86% had elevated left ventricular filling pressures at rest or with exercise, 81% had PH, and 20% of those with PH had concomitant right-sided heart failure.
Databáze: MEDLINE
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