Impaired left ventricular mechanics and functional reserve are associated with reduced exercise capacity in patients with hypertrophic cardiomyopathy
| Autor: | Qi-Zhe Cai, Yun-Yun Qin, Yidan Li, Xiaopeng Wu, Xiuzhang Lu, Weiwei Zhu, Wei Jiang, Miao Zhang, Xiao-Guang Ye, Lan-Lan Sun, Xue-Yan Ding |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Heart Ventricles Diastole Exercise intolerance 030204 cardiovascular system & hematology Metabolic equivalent Ventricular Dysfunction Left 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Mass index cardiovascular diseases 030212 general & internal medicine Ventricular mechanics Exercise Tolerance Receiver operating characteristic business.industry Hypertrophic cardiomyopathy Cardiomyopathy Hypertrophic Middle Aged Exercise capacity medicine.disease Echocardiography Exercise Test Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Echocardiography. 36:266-275 |
| ISSN: | 1540-8175 0742-2822 |
| DOI: | 10.1111/echo.14241 |
| Popis: | Background Reduced metabolic equivalents (METs) are an indicator of exercise intolerance, which predicts poor prognosis in hypertrophic cardiomyopathy (HCM) patients. We sought to evaluate the changes in left ventricular (LV) mechanics and functional reserves, as well as their association with functional capacity in HCM patients. Methods Seventy HCM patients and thirty controls were included in this study. LV mechanics were evaluated at rest and during exercise by echocardiography and two-dimensional speckle-tracking imaging to obtain parameters of functional reserve, LV global longitudinal strain (LVGLS), strain rate (SR), and circumferential strain. Results Hypertrophic cardiomyopathy (HCM) patients had lower LVGLS, systolic SR, early and late diastolic SR at rest and during exercise, and reduced absolute and relative systolic and diastolic reserve compared to controls. LV circumferential strain was significantly higher at rest but lower during exercise in HCM patients. Exercise capacity was markedly reduced in HCM patients, and peak exercise LVGLS (LVGLS-exe) significantly correlated with exercise capacity. Multivariate regression analyses showed that LVGLS-exe, LV filling pressure during exercise (E/e'-exe), and LV mass index (LVMI) were independent predictors of exercise capacity. Moreover, LVGLS-exe displayed incremental predictive value over E/e'-exe and LVMI for exercise intolerance. Receiver operating characteristic curve analysis showed LVGLS-exe had optimal accuracy for predicting exercise intolerance in HCM patients. Conclusions Hypertrophic cardiomyopathy (HCM) patients have reduced LV mechanics at rest and during exercise and impaired mechanical reserve. LVGLS-exe is associated with exercise capacity and is an optimal predictive value for reduced exercise capacity in HCM patients. |
| Databáze: | OpenAIRE |
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