Exercise limitation in hypertrophic cardiomyopathy: combined stress echocardiography and cardiopulmonary exercise test

• Published in: ESC Heart Failure 2024-08, Vol.11 (4), p.2287-2294
• Main Authors: Erez, Yonatan, Ghantous, Eihab, Shetrit, Aviel, Zamanzadeh, Ryan S., Zahler, David, Granot, Yoav, Sapir, Orly Ran, Laufer Perl, Michal, Banai, Shmuel, Topilsky, Yan, Havakuk, Ofer
• Format: Article
• Language: English
• Subjects: Age; Aged; Anaerobic threshold; Body mass index; Cardiac arrhythmia; Cardiomyopathy; Cardiomyopathy, Hypertrophic - physiopathology; Cardiopulmonary exercise test; Cardiovascular disease; Echocardiography, Stress - methods; Exercise intolerance; Exercise Test - methods; Exercise Tolerance - physiology; Female; Heart rate; Humans; Hypertrophic cardiomyopathy; Male; Maximum oxygen consumption; Metabolism; Middle Aged; Original; Oxygen Consumption - physiology; Patients; Pulmonary arteries; Stress echocardiography; Stroke Volume - physiology; Ventricular Function, Left - physiology
• ISSN: 2055-5822; 2055-5822
• DOI: 10.1002/ehf2.14776

Aims The study aims to investigate exercise‐limiting factors in hypertrophic cardiomyopathy (HCM) using combined stress echocardiography and cardiopulmonary exercise test. Methods and results A symptom‐limited ramp bicycle exercise test was performed in the semi‐supine position on a tilting dedicated ergometer. Echocardiographic images were obtained concurrently with gas exchange measurements along predefined stages of exercise. Oxygen extraction was calculated using the Fick equation at each activity level. Thirty‐six HCM patients (mean age 67 ± 6 years, 72% men, 18 obstructive HCM) were compared with age and sex‐matched 29 controls. At rest, compared with controls, E/E′ ratio (6.26 ± 2.3 vs. 14 ± 2.5, P