Exercise heart rates in patients with hypertrophic cardiomyopathy

Hong-Chang Luo; Veronica L Dimaano; Jackelyn M Kembro; Alex Hilser; David Hurtado-de-Mendoza; Iraklis Pozios; Miguel S Tomas; Hulya Yalcin; Ketty Dolores-Cerna; Wilfredo Mormontoy; Miguel A Aon; Duke Cameron; David A Bluemke; Kerry J Stewart; Stuart D Russell; Jorge G Cordova; Theodore P Abraham; M Roselle Abraham

doi:10.1016/j.amjcard.2015.01.548

Exercise heart rates in patients with hypertrophic cardiomyopathy

Am J Cardiol. 2015 Apr 15;115(8):1144-1150. doi: 10.1016/j.amjcard.2015.01.548. Epub 2015 Feb 4.

Authors

Hong-Chang Luo¹, Veronica L Dimaano², Jackelyn M Kembro², Alex Hilser², David Hurtado-de-Mendoza³, Iraklis Pozios², Miguel S Tomas², Hulya Yalcin², Ketty Dolores-Cerna², Wilfredo Mormontoy², Miguel A Aon², Duke Cameron⁴, David A Bluemke⁵, Kerry J Stewart², Stuart D Russell², Jorge G Cordova⁶, Theodore P Abraham², M Roselle Abraham⁷

Affiliations

¹ 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.
² Division of Cardiology, Johns Hopkins University, Baltimore, Maryland.
³ Division of Cardiology, Johns Hopkins University, Baltimore, Maryland; Faculty of Sciences, Department of Statistics, Demography, Humanities and Social Sciences, Cayetano Heredia University, Lima, Peru.
⁴ Division of Cardiac Surgery, Johns Hopkins University, Baltimore, Maryland.
⁵ Department of Radiology and Imaging Sciences, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, Maryland.
⁶ Faculty of Sciences, Department of Statistics, Demography, Humanities and Social Sciences, Cayetano Heredia University, Lima, Peru.
⁷ Division of Cardiology, Johns Hopkins University, Baltimore, Maryland. Electronic address: mabraha3@jhmi.edu.

Abstract

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.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cardiomyopathy, Hypertrophic / diagnosis
Cardiomyopathy, Hypertrophic / physiopathology*
Echocardiography, Doppler, Color
Electrocardiography*
Exercise / physiology*
Exercise Test / methods
Female
Follow-Up Studies
Heart Rate / physiology*
Heart Ventricles / physiopathology*
Humans
Male
Middle Aged
Positron-Emission Tomography
Prognosis
Recovery of Function*
Retrospective Studies
Severity of Illness Index
Tomography, X-Ray Computed
Ventricular Function, Left / physiology*

Grants and funding

R01 HL092985/HL/NHLBI NIH HHS/United States