Response of the stroke volume and blood pressure of young patients with nonobstructive hypertrophic cardiomyopathy to exercise.
Stroke volume (SV), cardiac output (CO) and systolic blood pressure (SBP) were measured during maximal symptom-limited bicycle exercise testing in 13 young patients (age, 11-26 years) with nonobstructive hypertrophic cardiomyopathy (HCM). SV was measured by impedance plethysmocardiography; %SVend, %COend, and %SBPend represent the ratio of the value at termination of the exercise to the respective value at rest. In all patients of HCM-I (the Cardiac Event Group, 3 patients) and 3 of HCM-II (the Non-Cardiac Event Group, 10 patients), the %SVend was less than 100%. The %SVend of HCM-I was significantly lower than the respective values of the HCM-II and Control groups. The %COend values of the HCM-I and HCM-II groups were each significantly lower than that of the Control. The %SBPend values of the HCM-I and HCM-II groups were each significantly lower than that of the Control. Among the HCM patients, the %SVend value was positively correlated with the %SBPend value. The patients who had more severe HCM had poorer exercise-induced increases in SV and SBP. These results suggest that sudden cardiac death in young HCM patients is associated with inhibition of the increase in SV upon exercise.
Yasui
K
K
Department of Pediatrics, Yokohama City University Medical Center, Japan. kyasui@urahp.yokohama-cu.ac.jp
Shibata
T
T
Nishizawa
T
T
Yokoyama
U
U
Takigiku
K
K
Sakon
T
T
Yamaoka
K
K
Kobayashi
H
H
Iwamoto
M
M
Sagawa
K
K
Niimura
I
I
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D002302:Cardiac Output; D002648:Child; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006323:Heart Arrest / Q000209:etiology; D006339:Heart Rate; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000473:pathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D007022:Hypotension / Q000209:etiology / Q000503:physiopathology; D008297:Male; D010992:Plethysmography, Impedance; D012306:Risk; D013318:Stroke Volume; D013575:Syncope / Q000209:etiology; D014463:Ultrasonography; D014655:Vascular Resistance