Prognostic Value of Reduced Heart Rate Reserve during Exercise in Hypertrophic Cardiomyopathy.
autonomic dysfunction
hypertrophic cardiomyopathy
stress echocardiography
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
24 Mar 2021
24 Mar 2021
Historique:
received:
23
02
2021
revised:
15
03
2021
accepted:
18
03
2021
entrez:
3
4
2021
pubmed:
4
4
2021
medline:
4
4
2021
Statut:
epublish
Résumé
Sympathetic dysfunction can be evaluated by heart rate reserve (HRR) with exercise test. To determine the value of HRR in predicting outcome of patients with hypertrophic cardiomyopathy (HCM). We enrolled 917 HCM patients (age = 49 ± 15 years, 516 men) assessed with exercise stress echocardiography (ESE) in 11 centres. ESE modality was semi-supine bicycle in 51 patients (6%), upright bicycle in 476 (52%), and treadmill in 390 (42%). During ESE, we assessed left ventricular outflow tract obstruction (LVOTO), stress-induced new regional wall motion abnormalities (RWMA), and HRR (peak/rest heart rate, HR). By selection, all patients completed the follow-up. Mortality was the predetermined outcome measure Results: During ESE, RWMA occurred in 22 patients (2.4%) and LVOTO (≥50 mmHg) in 281 (30.4%). HRR was 1.90 ± 0.40 (lowest quartile ≤ 1.61, highest quartile > 2.13). Higher resting heart rate (odds ratio 1.027, 95% CI: 1.018-1.036, A blunted HRR during ESE predicts survival independently of RWMA in HCM patients.
Sections du résumé
BACKGROUND
BACKGROUND
Sympathetic dysfunction can be evaluated by heart rate reserve (HRR) with exercise test.
OBJECTIVES
OBJECTIVE
To determine the value of HRR in predicting outcome of patients with hypertrophic cardiomyopathy (HCM).
METHODS
METHODS
We enrolled 917 HCM patients (age = 49 ± 15 years, 516 men) assessed with exercise stress echocardiography (ESE) in 11 centres. ESE modality was semi-supine bicycle in 51 patients (6%), upright bicycle in 476 (52%), and treadmill in 390 (42%). During ESE, we assessed left ventricular outflow tract obstruction (LVOTO), stress-induced new regional wall motion abnormalities (RWMA), and HRR (peak/rest heart rate, HR). By selection, all patients completed the follow-up. Mortality was the predetermined outcome measure Results: During ESE, RWMA occurred in 22 patients (2.4%) and LVOTO (≥50 mmHg) in 281 (30.4%). HRR was 1.90 ± 0.40 (lowest quartile ≤ 1.61, highest quartile > 2.13). Higher resting heart rate (odds ratio 1.027, 95% CI: 1.018-1.036,
CONCLUSIONS
CONCLUSIONS
A blunted HRR during ESE predicts survival independently of RWMA in HCM patients.
Identifiants
pubmed: 33805111
pii: jcm10071347
doi: 10.3390/jcm10071347
pmc: PMC8037369
pii:
doi:
Types de publication
Journal Article
Langues
eng
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