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Determinants of Exercise Capacity in Patients With Hypertrophic Cardiomyopathy
Ji-Won Hwang1, Sang-Chol Lee2,3, Darae Kim2,4
1Division of Cardiology, Department of Medicine, Ilsan Paik Hospital, Inje University School of Medicine, Goyang, Korea.
Journal of Korean Medical Science
|February 28, 2022
Summary
Exercise capacity in hypertrophic cardiomyopathy (HCM) is reduced by age, female sex, and elevated NT-proBNP and E/e
Area of Science:
- Cardiology
- Exercise Physiology
Background:
- Reduced exercise capacity is a key indicator of symptom severity and clinical outcomes in hypertrophic cardiomyopathy (HCM).
- Identifying factors influencing exercise capacity is crucial for managing HCM patients.
Purpose of the Study:
- To determine the clinical and laboratory factors associated with exercise capacity in patients with HCM and preserved left ventricular ejection fraction.
Main Methods:
- Cardiopulmonary exercise testing was used to measure peak oxygen consumption (peak VO2) in 294 HCM patients.
- Associations were analyzed with N-terminal pro-hormone of brain natriuretic peptide (NT-proBNP), echocardiographic diastolic parameters (E/e' ratio), and myocardial fibrosis on cardiac magnetic resonance imaging (CMR).
Main Results:
- Peak VO2 was significantly reduced in association with older age, female sex, higher NT-proBNP levels, and increased E/e' ratio.
- Myocardial fibrosis, assessed by late gadolinium enhancement on CMR, did not show a significant association with peak VO2.
Conclusions:
- Age, female sex, elevated NT-proBNP, and E/e' ratio are significant predictors of reduced exercise capacity in HCM.
- Monitoring hemodynamic changes and filling pressures via echocardiography is recommended for improved outcomes in HCM patients.
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