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

Damiano Magrì, Piergiuseppe Agostoni, Filippo Maria Cauti, Beatrice Musumeci, Gabriele Egidy Assenza, Carlo Nicola De Cecco, Giuseppe Muscogiuri, Antonello Maruotti, Agnese Ricotta, Erika Pagannone, Laura Marino, Daria Santini, Giulia Proietti, Andrea Serdoz, Francesco Paneni, Massimo Volpe, Camillo Autore

Research output: Contribution to journalArticlepeer-review

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 2 (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.

Original languageEnglish
Pages (from-to)293-302
Number of pages10
JournalInternal and Emergency Medicine
Volume9
Issue number3
DOIs
Publication statusPublished - 2014

Keywords

  • Cardiopulmonary exercise test
  • Chronotropic incompetence
  • Hypertrophyc cardiomyopathy

ASJC Scopus subject areas

  • Emergency Medicine
  • Internal Medicine
  • Medicine(all)

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