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Postprandial Hemodynamics in Hypertrophic Cardiomyopathy
Jonathon C Adams1, John P Bois2, Mitsuru Masaki2
1Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, Arizona.
Echocardiography (Mount Kisco, N.Y.)
|May 27, 2015
Summary
Postprandial symptoms in hypertrophic cardiomyopathy (HCM) patients do not appear to be caused by measurable hemodynamic changes in a resting, supine state. Further research is needed to determine if upright or exercise protocols can reveal dynamic left ventricular outflow tract obstruction.
Area of Science:
- Cardiology
- Cardiovascular Physiology
Background:
- Previous research linked postprandial symptoms (PPS) in hypertrophic cardiomyopathy (HCM) patients to resting left ventricular outflow tract (LVOT) obstruction and reduced quality of life.
- The underlying hemodynamic mechanisms of PPS in HCM remain unclear.
Purpose of the Study:
- To investigate whether postprandial symptoms (PPS) in HCM patients are associated with measurable hemodynamic alterations compared to healthy controls.
- To assess postprandial hemodynamic responses in HCM patients with and without PPS.
Main Methods:
- A prospective, cross-sectional study involving 45 HCM patients and 10 healthy controls.
- Fasting and postprandial 2-dimensional Doppler echocardiography were performed.
- Postprandial measurements were taken at symptom onset or 30 minutes after a standardized meal.
Main Results:
- No significant difference in mean resting peak LVOT gradient was observed between HCM patients with PPS and those without, compared to controls.
- The mean change in peak LVOT gradient post-meal was minimal and not statistically different across groups (controls, HCM with PPS, HCM without PPS).
Conclusions:
- A resting, supine postprandial protocol did not reveal evidence of LVOT obstruction in HCM patients with PPS.
- Future studies should explore upright or exercise-based postprandial protocols to investigate dynamic LVOT obstruction in HCM patients experiencing PPS.
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