CardiomyopathyExercise capacity in hypertrophic cardiomyopathy depends on left ventricular diastolic function
Section snippets
Patient selection
We studied 52 patients with HC (37 men and 15 women) aged 16 to 73 years (mean 41). The diagnosis of HC was made based on the M-mode and 2-dimensional echocardiographic evidence of a hypertrophied, nondilated left ventricle without any identifiable causes of secondary hypertrophy.8 All patients were in sinus rhythm and none had any conduction abnormalities or left or right bundle branch block. Twenty-nine patients were asymptomatic, 17 patients were mildly symptomatic (New York Heart
Patients’ characteristics
Maximum septal thickness averaged 21 ± 5 mm (range 15 to 32), the average value of posterior wall thickness was 10 ± 2 mm (range 7 to 16), and maximum lateral wall thickness averaged 13 ± 4 mm (range 7 to 20). Three patients were classified as type I, 35 as type II, and 14 as type III according to Maron’s classification. The hypertrophy score index ranged from 42 to 90 (mean 61 ± 15). LA diameters were: maximum 45 ± 7 mm (range 30 to 60) and minimum 35 ± 7 mm (range 22 to 54). LV fractional
Discussion
Diastolic dysfunction seems to be the most important determinant of exercise capacity in patients with HC.1 Lele et al1 have shown that the capability of increasing LV end-diastolic volume is likely the most important factor in cardiac output augmentation during exercise. In HC, where all phases of diastole are abnormal,21 the limited capability of increasing LV end-diastolic volume, especially during exercise at high rates (when LV diastolic filling time is shorter), implies an inadequate
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Circulation
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2022, European Journal of RadiologyMyocardial Contraction Fraction Predicts Cardiovascular Events in Patients With Hypertrophic Cardiomyopathy and Normal Ejection Fraction
2019, Journal of Cardiac FailureCitation Excerpt :One common feature of heart failure in HCM is reduced functional capacity. In previous reports, LVEF failed to correlate with functional capacity in HCM.6 This is consistent with the findings in the present study showing the lack of association between LVEF and NYHA functional class.
Genetic cardiomyopathies
2019, Emery and Rimoin's Principles and Practice of Medical Genetics and Genomics: Cardiovascular, Respiratory, and Gastrointestinal DisordersDissecting functional impairment in hypertrophic cardiomyopathy by dynamic assessment of diastolic reserve and outflow obstruction: A combined cardiopulmonary-echocardiographic study
2017, International Journal of CardiologyCitation Excerpt :This was reflected by higher E/e′ ratio values and larger LA volume index. Thus, resting obstruction and DD appear closely interrelated, and probably part of an adverse process leading from afterload mismatch to regional anisotropy of relaxation and impaired LV filling [37,38]. Obstruction is also associated with greater LV thickness and may worsen coronary microvascular dysfunction [39,40].
Hypertrophic Cardiomyopathy
2017, Cardioskeletal Myopathies in Children and Young Adults