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Relationship between baseline resting diastolic function and exercise capacity in patients with hypertrophic

Wael A Aljaroudi1, Milind Y Desai, M Chadi Alraies

  • 1Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.

BMJ Open
|December 18, 2012
PubMed

Insights

Diastolic dysfunction (DD) is common in hypertrophic cardiomyopathy (HCM) patients but does not predict exercise capacity. Other traditional risk factors are more significant predictors of maximal metabolic equivalents (METs) achieved.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Exercise Physiology

Background:

  • Diastolic dysfunction (DD) is frequently observed in patients with hypertrophic cardiomyopathy (HCM).
  • The direct impact of baseline diastolic function on exercise capacity in HCM remains incompletely understood.
  • Limited data exist on the predictive value of DD for exercise limitations in HCM.

Purpose of the Study:

  • To investigate the association between baseline diastolic function and exercise capacity in patients diagnosed with HCM.
  • To determine if diastolic dysfunction is an independent predictor of exercise performance in this population.

Main Methods:

  • Retrospective analysis of 695 consecutive HCM patients undergoing exercise stress echocardiography.
  • Diastolic function was assessed from resting echocardiograms by blinded cardiologists.
  • Maximal metabolic equivalents (METs) were recorded, and multivariate regression analysis identified predictors of METs achieved.

Main Results:

  • After exclusions, 495 patients were analyzed, with varying stages of diastolic dysfunction (DD).
  • Patients with advanced DD demonstrated lower maximal METs compared to those with normal diastolic function (p<0.0001).
  • However, baseline DD was not an independent predictor of maximal METs achieved after adjusting for other factors.

Conclusions:

  • Baseline diastolic dysfunction is prevalent in HCM patients.
  • Diastolic dysfunction does not independently predict exercise capacity (maximal METs) in HCM.
  • Traditional risk factors appear to be more influential in determining exercise limitations in HCM patients.
Abstract

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