Exercise heart rates in patients with hypertrophic cardiomyopathy.
The exercise heart rate (HR) profile and its relation to cardiac function and arrhythmias were investigated in patients with hypertrophic cardiomyopathy (HC). Chronotropic response (CR) and heart rate recovery (HRR) were computed during and after treadmill exercise testing in 273 patients with HC and 95 age-matched healthy controls. Patients with HC had higher prevalence of chronotropic incompetence and lower HRR1-5min compared with controls. Exercise capacity, diastolic function (assessed by E/e') and left atrial volume index were associated with HRR1min and CR in HC. Septal myectomy was associated with reduction in chronotropic incompetence but did not affect HRR1min. In conclusion, impaired CR and HRR1min are associated with advanced disease and do not appear to be independent clinical markers indicating high-risk status in HC. Improving CR by titrating doses of negative chronotropic agents, myectomy, and atrial pacing may be useful to increase exercise capacity in patients with HC.
Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Division of Cardiology, Johns Hopkins University, Baltimore, Maryland.
Hong-Chang
HC
Luo
Division of Cardiology, Johns Hopkins University, Baltimore, Maryland.
Veronica L
VL
Dimaano
Division of Cardiology, Johns Hopkins University, Baltimore, Maryland.
Jackelyn M
JM
Kembro
Division of Cardiology, Johns Hopkins University, Baltimore, Maryland.
Alex
A
Hilser
Division of Cardiology, Johns Hopkins University, Baltimore, Maryland; Faculty of Sciences, Department of Statistics, Demography, Humanities and Social Sciences, Cayetano Heredia University, Lima, Peru.
David
D
Hurtado-de-Mendoza
Division of Cardiology, Johns Hopkins University, Baltimore, Maryland.
Iraklis
I
Pozios
Division of Cardiology, Johns Hopkins University, Baltimore, Maryland.
Miguel S
MS
Tomas
Division of Cardiology, Johns Hopkins University, Baltimore, Maryland.
Hulya
H
Yalcin
Division of Cardiology, Johns Hopkins University, Baltimore, Maryland.
Ketty
K
Dolores-Cerna
Division of Cardiology, Johns Hopkins University, Baltimore, Maryland.
Wilfredo
W
Mormontoy
Division of Cardiology, Johns Hopkins University, Baltimore, Maryland.
Miguel A
MA
Aon
Division of Cardiac Surgery, Johns Hopkins University, Baltimore, Maryland.
Duke
D
Cameron
Department of Radiology and Imaging Sciences, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, Maryland.
David A
DA
Bluemke
Division of Cardiology, Johns Hopkins University, Baltimore, Maryland.
Kerry J
KJ
Stewart
Division of Cardiology, Johns Hopkins University, Baltimore, Maryland.
Stuart D
SD
Russell
Faculty of Sciences, Department of Statistics, Demography, Humanities and Social Sciences, Cayetano Heredia University, Lima, Peru.
Jorge G
JG
Cordova
Division of Cardiology, Johns Hopkins University, Baltimore, Maryland.
Theodore P
TP
Abraham
Division of Cardiology, Johns Hopkins University, Baltimore, Maryland. Electronic address: mabraha3@jhmi.edu.
M Roselle
MR
Abraham
D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis / Q000503:physiopathology*; D018618:Echocardiography, Doppler, Color; D004562:Electrocardiography; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology*; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016277:Ventricular Function, Left / Q000502:physiology*