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[The characteristics of core parameters during cardiopulmonary exercise testing in patients with hypertrophy

Ying-Zhe Chen1,2,3, Xing-Guo Sun1,2,3, Wen-Qi Tai1,2,3

  • 11. National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences, Pebing Union Medical College, National Center for Cardiovascular Disease, Key Laboratory of Cardiovascular Diseases, Beijing 100037.

Zhongguo Ying Yong Sheng Li Xue Za Zhi = Zhongguo Yingyong Shenglixue Zazhi = Chinese Journal of Applied Physiology
|October 21, 2021
PubMed

Insights

Cardiopulmonary exercise testing (CPET) reveals significant exercise pathophysiology in Hypertrophic Cardiomyopathy (HCM) patients, showing decreased peak oxygen uptake and anaerobic threshold. CPET is a safe and specific tool for evaluating HCM functional status and guiding personalized management.

Area of Science:

  • Cardiology
  • Exercise Physiology
  • Integrative Physiology

Background:

  • Hypertrophic Cardiomyopathy (HCM) presents a high risk of sudden death, yet its exercise pathophysiology remains unclear.
  • Holistic Integrative Physiology and Medicine (HIPM) emphasizes comprehensive patient evaluation.
  • Cardiopulmonary Exercise Testing (CPET) is a key method for assessing overall functional capacity.

Purpose of the Study:

  • To investigate the cardiopulmonary exercise testing (CPET) pathophysiology in patients with Hypertrophic Cardiomyopathy (HCM).
  • To evaluate the functional status and exercise capacity of HCM patients using CPET.

Main Methods:

  • A total of 244 subjects (219 HCM patients, 25 healthy normal subjects) underwent symptom-limited ramp protocol CPET.
  • Core CPET parameters including peak oxygen uptake (Peak VO2), anaerobic threshold (AT), and VE/VCO2 slope were measured and compared between groups.
  • Individual analysis of CPET parameters was performed to assess the range of functional status in HCM patients.

Main Results:

  • HCM patients demonstrated significantly decreased Peak VO2, AT, and Peak O2 pulse compared to normal subjects (P<0.01 or P<0.05).
  • HCM patients showed significantly increased Lowest VE/VCO2 and VE/VCO2 Slope (P<0.05).
  • Peak VO2 correlated positively with AT, OUEP, Peak O2 pulse, and systolic blood pressure, but negatively with Lowest VE/VCO2 and VE/VCO2 Slope.

Conclusions:

  • CPET is a safe and specific diagnostic tool for patients with HCM, offering valuable insights into their exercise pathophysiology.
  • Under HIPM guidance, CPET aids in functional evaluation, diagnosis, risk stratification, and prognosis prediction for HCM.
  • CPET findings can inform individualized training prescriptions and chronic disease management strategies for HCM patients.

Keywords:
holistic integrative physiology and medicinehypertrophic cardiomyopathyoverall function is limitedsports pathophysiologysymptom-restricted cardiopulmonary exercise testing

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