title: Relationships among exercise capacity, hypertrophy, and left ventricular diastolic function in nonobstructive hypertrophic cardiomyopathy.
abstract: OBJECTIVE
  The aim of this study was to analyze the relationships among exercise capacity (EC), hypertrophy, and diastolic function in nonobstructive hypertrophic cardiomyopathy (NOHCM).
  
  
  RESULTS
  Twenty-seven patients with NOHCM were studied. Left ventricular hypertrophy (LVH) was determined by appropriate echocardiographic indexes. For diastolic function evaluation, the following were measured: the early (E) and late (A) waves, E/A, and deceleration time of E of the mitral flow; the systolic (S), diastolic (D), and atrial reversal (AR) waves, S/D, and the atrial systolic filling fraction of the pulmonary vein flow; and the early (Ea), late (Aa) waves, Ea/Aa, and E/Ea by tissue Doppler imaging. The difference between the duration of AR and A waves (DurAR - DurA), the peak VO2, and anaerobic threshold (AT) were also determined. In these patients, the E/Ea ratio was 8.9 +/- 3.2 and DurAR - DurA was 22.6 +/- 32.6 milliseconds. The peak VO2 and AT correlated with D (r = 0.55, P = .003 and .51, P = .007, respectively) and Ea/Aa (r = 0.56, P = .007 and .45, P = .03, respectively). There was no correlation between EC and LVH.
  
  
  CONCLUSIONS
  Patients with NOHCM demonstrated evidences of elevated left ventricular (LV) end-diastolic pressure with normal filling pressure. EC compromise may be attributed to relaxation changes with inadequate filling of the left ventricle.
authors.affiliation: Departmnet of Cardiomyopathy, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil. fymatsumoto@superig.com.br
authors.forename: Afonso Y
authors.initials: AY
authors.lastname: Matsumoto
authors.forename: Edmundo
authors.initials: E
authors.lastname: Arteaga
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Ianni
authors.forename: Ana M F W
authors.initials: AM
authors.lastname: Braga
authors.forename: Paula C
authors.initials: PC
authors.lastname: Buck
authors.forename: Charles
authors.initials: C
authors.lastname: Mady
mesh_terms: D000293:Adolescent; D000328:Adult; D006332:Cardiomegaly / Q000150:complications*; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications* / Q000503:physiopathology*; D003971:Diastole; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016277:Ventricular Function, Left