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Impaired Left Ventricular Contractile Reserve in Patients With Hypertrophic Cardiomyopathy and Abnormal Blood

Mayumi Takeoka1, Michiyo Yamano1,2, Sakiko Honda1

  • 1Department of Cardiology, Matsushita Memorial Hospital, Moriguchi, JPN.

Cureus
|January 5, 2023
PubMed

Insights

Abnormal blood pressure response during exercise in hypertrophic cardiomyopathy (HCM) patients is linked to reduced left ventricular contractile reserve. This finding suggests impaired cardiac function may underlie exercise blood pressure abnormalities in HCM.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Exercise Physiology

Background:

  • Abnormal blood pressure response (ABPR) is a known risk factor for sudden cardiac death in hypertrophic cardiomyopathy (HCM).
  • The relationship between ABPR during exercise and left ventricular (LV) contractile reserve in HCM patients requires further investigation.

Purpose of the Study:

  • To investigate the association between ABPR during exercise stress echocardiography (ESE) and impaired LV contractile reserve in HCM patients.
  • To determine if reduced two-dimensional strain parameters correlate with ABPR during ESE in HCM.

Main Methods:

  • 26 HCM patients underwent ESE with treadmill exercise.
  • ABPR was defined as a blood pressure increase <20 mmHg from baseline at maximum workload.
  • LV global longitudinal strain and other echocardiographic parameters were compared between patients with and without ABPR.

Main Results:

  • Nine out of 26 HCM patients exhibited ABPR.
  • No significant differences in cardiac output or E/e' ratio changes were observed between groups.
  • Patients with ABPR showed a significantly lower percent change in LV global longitudinal strain compared to those without ABPR (12±17% vs. 27±15%, P=0.02).

Conclusions:

  • Impaired LV contractile reserve during exercise may contribute to ABPR in HCM patients.
  • Reduced LV global longitudinal strain during exercise is associated with ABPR in HCM.
Abstract

Keywords:
2d-speckle trackingabnormal blood pressure responsedoppler echocariographyexercise stress echocardiographyhypertrophic cardiomyopathy

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