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Decreased exercise capacity and sleep-disordered breathing in patients with hypertrophic cardiomyopathy

Tomas Konecny1, Jeffrey B Geske2, Ondrej Ludka3

  • 1Mayo Clinic, Rochester, MN; St. Anne's University Hospital, International Clinical Research Center (ICRC), Brno, Czech Republic.

Chest
|January 31, 2015
PubMed

Insights

Sleep-disordered breathing (SDB) significantly reduces exercise capacity in hypertrophic cardiomyopathy (HCM) patients. Addressing SDB may improve fitness in this population.

Area of Science:

  • Cardiology
  • Sleep Medicine
  • Exercise Physiology

Background:

  • Hypertrophic cardiomyopathy (HCM) is associated with reduced exercise capacity.
  • Sleep-disordered breathing (SDB) is common in HCM patients but its impact on exercise capacity is unknown.

Purpose of the Study:

  • To investigate the association between SDB and exercise capacity in patients with HCM.
  • To determine if SDB is a contributing factor to impaired exercise tolerance in HCM.

Main Methods:

  • Consecutive HCM patients underwent overnight oximetry, cardiopulmonary exercise testing, and echocardiography.
  • SDB was diagnosed based on an oxygen desaturation index ≥ 10.
  • Peak oxygen consumption (VO2 peak) was correlated with SDB presence and severity.

Main Results:

  • 32% of 198 HCM patients had SDB.
  • Patients with SDB exhibited significantly lower VO2 peak (16 mL O2/kg/min) compared to those without SDB (21 mL O2/kg/min).
  • SDB remained a significant independent predictor of reduced VO2 peak after adjusting for clinical confounders.

Conclusions:

  • SDB is associated with decreased exercise capacity (VO2 peak) in HCM patients.
  • SDB is a potential, modifiable contributor to exercise intolerance in HCM.
  • Further research into SDB management for improving exercise tolerance in HCM is warranted.
Abstract

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