Russian Heart Failure Journal 2010year Dynamic exercise capacity in patients with hypertrophic cardiomyopathy
Dynamic exercise capacity in patients with hypertrophic cardiomyopathy
Chernyavskaya M. O., Bogdanov D. V.
Keywords: hypertrophic cardiomyopathy, exercise capacity, bicycle ergometry, echocardiography
Actuality. Exercise capacity in patients with hypertrophic cardiomyopathy (GCM) is poorly understood. Aim. To determine the impact of dynamic load on the main clinical and instrumental parameters of heart activity in patients with GCM. Materials and methods. The study included 89 patients with GCM. Echocardiograthy, ECG, bicycle ergometry were preforned. Results. In patients with GCM tolerability of bicycle ergometry did not differ significantly from that in healthy people. At the same time ending the test in 44 % of cases was associated with an irresistible fatigue, in 43 % – with the achievement of submaximal heart rate. Duration and power of bicycle ergometry results decreased with increasing of CHF FC. Exercise capacity correlated with systolic and diastolic function of left ventricle, but also with right ventricle. Patients with preserved cardiac function at rest bore the load better. In 36 % reduced contractility of LV interventricular septum and posterior wall was observed during the load. In 48 % of cases increased severity of LV diastolic dysfunction was revealed. In non-obstructive hypertrophic cardiomyopathy significant increase of LV wall thickening fraction was observed during the load, and in hypertrophic obstructive cardiomyopathy this index did not change significantly. In 32 % of cases of GCM stroke volume reduction was observed due to dynamic load, and in 8 % of cases – more than 30 % of the basic value. Stroke volume reduction is more prevalent in patients with high pulse BP at the last stage of bicycle ergometry. Stroke volume reduction of >30 % defines low exercise capacity. The method of calculating of stress-induced stroke volume dynamics by echocardiography is offered.
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Chernyavskaya M. O., Bogdanov D. V. Dynamic exercise capacity in patients with hypertrophic cardiomyopathy. Russian Heart Failure Journal. 2010;11(2):108-111.