Abnormal blood pressure response to exercise occurs more frequently in hypertrophic cardiomyopathy patients with the R92W troponin T mutation than in those with myosin mutations

Marshall Heradien, Miriam Revera, Lize Van Der Merwe, Althea Goosen, Valerie A. Corfield, Paul A. Brink, Bongani M. Mayosi, Johanna C. Moolman-Smook

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Abnormal blood pressure response to exercise is reported to occur in up to a third of hypertrophic cardiomyopathy (HCM) cases and is associated with an increased risk of death, particularly in the young, but it is not known whether the HCM-causing mutation influences blood pressure response to exercise. The purpose of this article is to ascertain whether the blood pressure response to exercise differs among carriers of the R92W mutation in the cardiac troponin T gene (TNNT2), which has been associated with an increased risk of sudden cardiac death in young males; carriers of mutations in the cardiac β-myosin heavy chain gene (MYH7); and their noncarrier relatives. Thirty R92W TNNT2 carriers, 51 MYH7 mutation carriers, and 68 of their noncarrier relatives were subjected to bicycle ergonometric exercise testing to assess blood pressure response to, as well as heart rate recovery after, exercise. Additional echocardiographic and demographic details were documented for all participants. R92W TNNT2 carriers demonstrated significantly more abnormal blood pressure responses to exercise (P = .021; odds ratio 3.03; confidence interval 1.13- 8.12) and smaller increases in systolic blood pressure than MYH7 mutation carriers or related noncarrier control individuals. Although abnormal blood pressure response occurred at similar frequencies in males in all groups (23%-26%), the percentage of R92W TNNT2 females with abnormal blood pressure response was 64%, compared with 25% for MYH7 and 22% for noncarriers. Therefore, these results show that blood pressure response to exercise is influenced by genotype and gender in patients with HCM.

Original languageEnglish
JournalHeart Rhythm
Volume6
Issue number11 SUPPL.
DOIs
Publication statusPublished - Nov 2009

Fingerprint

Troponin T
Hypertrophic Cardiomyopathy
Myosins
Exercise
Blood Pressure
Mutation
Cardiac Myosins
Myosin Heavy Chains
Sudden Cardiac Death
Genes
Heart Rate
Odds Ratio
Genotype
Demography
Confidence Intervals

Keywords

  • Abnormal blood pressure response
  • Beta-myosin
  • Genetic mutation
  • Hypertrophic cardiomyopathy
  • Survival
  • Troponin T

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

Cite this

Abnormal blood pressure response to exercise occurs more frequently in hypertrophic cardiomyopathy patients with the R92W troponin T mutation than in those with myosin mutations. / Heradien, Marshall; Revera, Miriam; Van Der Merwe, Lize; Goosen, Althea; Corfield, Valerie A.; Brink, Paul A.; Mayosi, Bongani M.; Moolman-Smook, Johanna C.

In: Heart Rhythm, Vol. 6, No. 11 SUPPL., 11.2009.

Research output: Contribution to journalArticle

Heradien, Marshall ; Revera, Miriam ; Van Der Merwe, Lize ; Goosen, Althea ; Corfield, Valerie A. ; Brink, Paul A. ; Mayosi, Bongani M. ; Moolman-Smook, Johanna C. / Abnormal blood pressure response to exercise occurs more frequently in hypertrophic cardiomyopathy patients with the R92W troponin T mutation than in those with myosin mutations. In: Heart Rhythm. 2009 ; Vol. 6, No. 11 SUPPL.
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abstract = "Abnormal blood pressure response to exercise is reported to occur in up to a third of hypertrophic cardiomyopathy (HCM) cases and is associated with an increased risk of death, particularly in the young, but it is not known whether the HCM-causing mutation influences blood pressure response to exercise. The purpose of this article is to ascertain whether the blood pressure response to exercise differs among carriers of the R92W mutation in the cardiac troponin T gene (TNNT2), which has been associated with an increased risk of sudden cardiac death in young males; carriers of mutations in the cardiac β-myosin heavy chain gene (MYH7); and their noncarrier relatives. Thirty R92W TNNT2 carriers, 51 MYH7 mutation carriers, and 68 of their noncarrier relatives were subjected to bicycle ergonometric exercise testing to assess blood pressure response to, as well as heart rate recovery after, exercise. Additional echocardiographic and demographic details were documented for all participants. R92W TNNT2 carriers demonstrated significantly more abnormal blood pressure responses to exercise (P = .021; odds ratio 3.03; confidence interval 1.13- 8.12) and smaller increases in systolic blood pressure than MYH7 mutation carriers or related noncarrier control individuals. Although abnormal blood pressure response occurred at similar frequencies in males in all groups (23{\%}-26{\%}), the percentage of R92W TNNT2 females with abnormal blood pressure response was 64{\%}, compared with 25{\%} for MYH7 and 22{\%} for noncarriers. Therefore, these results show that blood pressure response to exercise is influenced by genotype and gender in patients with HCM.",
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