Decreased biventricular mechanics and functional reserve in nonobstructive hypertrophic cardiomyopathy patients: implications for exercise capacity

Autor: Miao Zhang, Yidan Wang, Yun-Yun Qin, Di-Chen Guo, Weiwei Zhu, Xiaopeng Wu, Yidan Li, Xiuzhang Lu, Qi-Zhe Cai, Zhe Jiang, Wei Jiang, Xue-Yan Ding, Xiaoguang Ye, Lan-Lan Sun
Rok vydání: 2019
Předmět:
Adult
Male
Diastole
Exercise intolerance
030204 cardiovascular system & hematology
Logistic regression
Ventricular Function
Left
Metabolic equivalent
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
medicine
Humans
Radiology
Nuclear Medicine and imaging
030212 general & internal medicine
Echocardiography
Doppler
Pulsed
Observer Variation
Exercise Tolerance
Receiver operating characteristic
business.industry
Hypertrophic cardiomyopathy
Area under the curve
Reproducibility of Results
Mechanics
Cardiomyopathy
Hypertrophic
Middle Aged
Exercise capacity
medicine.disease
Myocardial Contraction
Biomechanical Phenomena
Case-Control Studies
Exercise Test
Ventricular Function
Right
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Echocardiography
Stress
Zdroj: The International Journal of Cardiovascular Imaging. 35:869-879
ISSN: 1573-0743
1569-5794
DOI: 10.1007/s10554-019-01530-y
Popis: The present study investigated the changes of biventricular mechanics at rest and during exercise and examined the association between exercise capacity and biventricular mechanics and functional reserve in nonobstructive hypertrophic cardiomyopathy (NHCM) patients. A total of 50 NHCM patients and 25 controls were consecutively recruited for this study. Using echocardiography and two-dimensional speckle-tracking imaging, an experienced echocardiographer determined the following indices: RV free wall longitudinal strain (RVFWLS), LV global longitudinal strain (LVGLS), strain rate (SR), and functional reserve of strain values. We also investigated the relationships between biventricular mechanics and exercise capacity using metabolic equivalents (METs). NHCM patients had lower RVFWLS, LVGLS, systolic SR, early diastolic SR, and systolic and diastolic reserve during exercise compared to controls. An association of biventricular mechanics (LVGLS, RVFWLS) with exercise capacity at rest and during exercise was established. Multivariable logistic regression revealed that RVFWLS and LVE/e' during exercise (RVFWLS-exe, E/e'-exe) were independent predictors of exercise intolerance. Receiver operating characteristic curve analysis indicated that LVE/e'-exe had a higher area under the curve for predicting exercise intolerance in NHCM patients. In hierarchical analysis, RVFWLS-exe provided an incremental predictive value of exercise intolerance over LVGLS during exercise (LVGLS-exe) and LVE/e'-exe. LVE/e'-exe also changed incrementally compared to LVGLS-exe and RVFWLS-exe. NHCM patients have decreased biventricular mechanics at rest and during exercise and impaired biventricular functional reserve, and biventricular mechanics are associated with functional capacity. We propose that simultaneous evaluation of biventricular function should provide incremental predictive value for exercise intolerance.
Databáze: OpenAIRE
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