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Decreased biventricular mechanics and functional reserve in nonobstructive hypertrophic cardiomyopathy patients:

Xiao-Peng Wu1, Yi-Dan Li1, Yi-Dan Wang1

  • 1Department of Echocardiography, Heart Center, Beijing Chao Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, People's Republic of China.

The International Journal of Cardiovascular Imaging
|January 19, 2019
PubMed

Insights

Nonobstructive hypertrophic cardiomyopathy (NHCM) patients exhibit reduced biventricular mechanics and impaired functional reserve. Biventricular mechanics are linked to exercise capacity, with specific measures predicting exercise intolerance.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Exercise Physiology

Background:

  • Nonobstructive hypertrophic cardiomyopathy (NHCM) is characterized by left ventricular hypertrophy without significant outflow tract obstruction.
  • Assessing biventricular mechanics and functional reserve is crucial for understanding exercise capacity limitations in NHCM patients.

Purpose of the Study:

  • To investigate changes in biventricular mechanics at rest and during exercise in NHCM patients.
  • To examine the association between exercise capacity and biventricular mechanics and functional reserve.
  • To identify predictors of exercise intolerance in NHCM.

Main Methods:

  • Echocardiography and 2D speckle-tracking imaging were used to assess biventricular mechanics (RVFWLS, LVGLS, SR) and functional reserve.
  • Exercise capacity was evaluated using metabolic equivalents (METs).
  • Multivariable logistic regression and ROC curve analysis were employed to identify predictors of exercise intolerance.

Main Results:

  • NHCM patients demonstrated reduced RV free wall longitudinal strain (RVFWLS), LV global longitudinal strain (LVGLS), and strain rate (SR) compared to controls.
  • Biventricular mechanics and functional reserve were impaired in NHCM patients at rest and during exercise.
  • RVFWLS and LVE/e' during exercise were independent predictors of exercise intolerance, with LVE/e' showing higher predictive accuracy.

Conclusions:

  • NHCM patients exhibit decreased biventricular mechanics and impaired functional reserve, impacting exercise capacity.
  • Simultaneous evaluation of biventricular function provides incremental predictive value for exercise intolerance in NHCM.
  • Biventricular mechanics are significantly associated with exercise capacity in NHCM.

Keywords:
Biventricular mechanicsExercise echocardiographyNonobstructive hypertrophic cardiomyopathySpeckle-tracking imaging

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