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Abnormal blood-pressure response to exercise and oxygen consumption in patients with hypertrophic cardiomyopathy

Quirino Ciampi1, Sandro Betocchi, Maria Angela Losi

  • 1Department of Clinical Medicine, Federico II University School of Medicine, Naples, Italy.

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
|November 21, 2007
PubMed

Insights

Abnormal blood-pressure response during exercise in hypertrophic cardiomyopathy (HCM) is linked to impaired left-ventricular (LV) function and reduced oxygen consumption. This hemodynamic instability may increase the risk of sudden cardiac death in HCM patients.

Area of Science:

  • Cardiology
  • Exercise Physiology

Background:

  • Abnormal blood-pressure response during exercise affects approximately one-third of patients with hypertrophic cardiomyopathy (HCM).
  • This exercise-induced phenomenon has been associated with an elevated risk of sudden cardiac death in HCM patients.

Purpose of the Study:

  • To assess the exercise hemodynamics in HCM patients exhibiting an abnormal blood-pressure response.
  • To evaluate left-ventricular (LV) function using ambulatory radionuclide monitoring (VEST) and exercise tolerance via oxygen consumption.

Main Methods:

  • Twenty-two HCM patients underwent treadmill exercise with VEST monitoring.
  • Cardiopulmonary exercise testing was conducted post-VEST.
  • Hemodynamic parameters (stroke volume, cardiac output, systemic vascular resistance) were measured as a percentage of baseline, alongside maximal oxygen consumption.

Main Results:

  • HCM patients with abnormal blood-pressure response (36%) showed greater increases in end-systolic volume and larger decreases in ejection fraction and stroke volume compared to those with normal response.
  • Cardiac output increased less in patients with abnormal blood-pressure response.
  • Maximal predicted oxygen consumption was significantly lower in HCM patients with abnormal blood-pressure response.

Conclusions:

  • An abnormal blood-pressure response during exercise in HCM patients is associated with exercise-induced LV systolic dysfunction.
  • Impaired oxygen consumption is also linked to abnormal blood-pressure response in HCM.
  • These findings suggest potential hemodynamic instability, contributing to the high risk of sudden cardiac death in affected individuals.
Abstract

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