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


Magrì, Damiano, Agostoni, Piergiuseppe and Cauti, Fillippo Maria et al. (2012) Determinants of peak oxygen uptake in patients with hypertrophic cardiomyopathy: a single-center study. Internal and Emergency Medicine (doi:10.1007/s11739-012-0866-x).

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Description/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.

Item Type: Article
ISSNs: 1828-0447 (print)
1970-9366 (electronic)
Keywords: hypertrophyc cardiomyopathy, cardiopulmonary exercise test, chronotropic incompetence
Subjects: H Social Sciences > HA Statistics
R Medicine > RC Internal medicine
Divisions: Faculty of Social and Human Sciences > Southampton Statistical Sciences Research Institute
Faculty of Social and Human Sciences > Mathematical Sciences > Statistics
ePrint ID: 343942
Date Deposited: 15 Oct 2012 09:12
Last Modified: 27 Mar 2014 20:26
URI: http://eprints.soton.ac.uk/id/eprint/343942

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