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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
PubMed

Insights

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.
Abstract

Keywords:
Exercise CapacityHypertrophic CardiomyopathyMyocardial Fibrosis

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