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Utility of tissue Doppler imaging to predict exercise capacity in hypertrophic cardiomyopathy: comparison with B-type
Hiroaki Kitaoka1, Toru Kubo, Makoto Okawa
1Division of Cardiology, Department of Medicine and Geriatrics, Kochi Medical School, Kochi, Japan. kitaokah@kochi-u.ac.jp
Insights
Tissue Doppler Imaging (TDI) of diastolic function, not B-type natriuretic peptide (BNP) levels, better predicts exercise capacity in hypertrophic cardiomyopathy (HCM) patients. This finding aids in managing HCM patients without systolic impairment or atrial fibrillation.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Biomarkers
Background:
- Left ventricular diastolic function and B-type natriuretic peptide (BNP) levels may correlate with functional status in hypertrophic cardiomyopathy (HCM).
- Predictive value of tissue Doppler imaging (TDI) versus BNP for exercise capacity in HCM patients without systolic impairment or atrial fibrillation remains unclear.
Purpose of the Study:
- To directly compare the clinical relevance of TDI-assessed diastolic function and plasma BNP levels in predicting exercise capacity in HCM patients.
Main Methods:
- Evaluated diastolic function using TDI and plasma BNP levels in 31 HCM patients.
- Assessed exercise capacity via peak oxygen consumption (VO2) using cardiopulmonary exercise tests.
Main Results:
- Lateral E/Ea ratio by TDI significantly correlated with peak VO2 (r=-0.52, p=0.003).
- Transmitral flow E/A ratio did not correlate with peak VO2.
- Plasma BNP levels did not significantly relate to peak VO2 but correlated with NYHA class.
Conclusions:
- TDI assessment of diastolic function is more valuable than plasma BNP levels for predicting objective exercise capacity in HCM patients.
- This finding is specific to HCM patients without systolic impairment and/or atrial fibrillation.
Background:
Recent reports suggest that left ventricular diastolic function assessed by tissue Doppler imaging (TDI) and plasma B-type natriuretic peptide (BNP) levels can relate to functional status in patients with hypertrophic cardiomyopathy (HCM). However, it is unclear which is more useful to predict the exercise capacity in HCM patients without systolic impairment and/or atrial fibrillation, TDI or BNP levels.
Purpose:
The present study directly compared the clinical relevance of assessing diastolic function using TDI and measuring the plasma BNP level in patients with HCM.
Methods And Subjects:
We evaluated diastolic function using TDI as well as plasma BNP levels in 31 patients (52.2+/-16.9 years of age; 20 males) with HCM and examined the relationship of these values to exercise capacity (peak O(2) consumption (VO(2))) measured by cardiopulmonary exercise tests.
Results:
Average peak VO(2) was 18.5+/-4.7 ml/(kg min). Although the E/A ratio by transmitral flow was not correlated with peak VO(2), the lateral E/E(a) ratio assessed by TDI was significantly correlated with peak VO(2) (r=-0.52, p=0.003). On the other hand, plasma BNP level was not significantly related to peak VO(2) but NYHA class.
Conclusions:
Assessment of diastolic function using TDI, not plasma BNP levels, is more useful for predicting objective exercise capacity in HCM patients without systolic impairment and/or atrial fibrillation.
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