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Exercise heart rates in patients with hypertrophic cardiomyopathy

Hong-Chang Luo1, Veronica L Dimaano2, Jackelyn M Kembro2

  • 1Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Division of Cardiology, Johns Hopkins University, Baltimore, Maryland.

The American Journal of Cardiology
|March 10, 2015
PubMed

Insights

Patients with hypertrophic cardiomyopathy (HC) show impaired exercise heart rate response, linked to disease severity. Interventions like myectomy may improve chronotropic response but not heart rate recovery, suggesting these are not independent high-risk markers.

Area of Science:

  • Cardiology
  • Exercise Physiology

Background:

  • Hypertrophic cardiomyopathy (HC) affects cardiac function and can lead to arrhythmias.
  • Exercise heart rate (HR) dynamics, including chronotropic response (CR) and heart rate recovery (HRR), are crucial indicators of cardiovascular health.

Purpose of the Study:

  • To investigate the exercise HR profile in patients with HC.
  • To determine the relationship between CR, HRR, cardiac function, and arrhythmias in HC.
  • To assess the impact of septal myectomy on CR and HRR in HC patients.

Main Methods:

  • Treadmill exercise testing was performed in 273 HC patients and 95 controls.
  • Chronotropic response (CR) and heart rate recovery (HRR) were calculated.
  • Diastolic function (E/e') and left atrial volume index were assessed.

Main Results:

  • HC patients exhibited higher prevalence of chronotropic incompetence and lower HRR (1-5 min) compared to controls.
  • Exercise capacity, diastolic function, and left atrial volume index correlated with HRR1min and CR in HC.
  • Septal myectomy reduced chronotropic incompetence but did not alter HRR1min.

Conclusions:

  • Impaired CR and HRR1min in HC are associated with advanced disease, not independent high-risk markers.
  • Improving CR through medication, myectomy, or pacing may enhance exercise capacity in HC patients.

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