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Is diastolic dysfunction a good surrogate of functional capacity in patients with hypertrophic cardiomyopathy?
Session:
Posters - F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Speaker:
Isabel Cardoso
Congress:
CPC 2021
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.3 Myocardial Disease – Diagnostic Methods
Session Type:
Posters
FP Number:
---
Authors:
Isabel Gonçalves Machado Cardoso; Sílvia Aguiar Rosa; Luísa Branco; Ana Galrinho; Pedro Rio; Pedro Brás; Ana Leal; Ana Sofia Silva; António Fiarresga; Luís Lopes; Miguel Mota Carmo; Rui Cruz Ferreira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Introduction: </u>Cardiopulmonary exercise test (CPET) provides detailed information about hypertrophic cardiomyopathy (HCM) patient’s functional capacity, which is in part influenced by left ventricular diastolic dysfunction (DD). The correlation between functional capacity and echocardiographic parameters of DD has not yet been well validated. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Objective: </u>To study the correlation between different resting diastolic echocardiographic parameters with functional capacity in HCM patients (P). </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Methods:</u> HCM patients seen at outpatient cardiomyopathy clinic at a tertiary centre were included. All patients underwent comprehensive transthoracic echocardiogram and CPET. The variables were analysed using Spearman rank correlation. </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Results</u>: Of 67 P with HCM (mean age 57 ± 14 years, 41 males), 38 P (56.7%) were in New York Heart Association (NYHA) functional class I, 24 (35.8%) in class II and 5 (7.5%) in class III. Obstructive HCM was present in 46 (68.7%), with a maximum left ventricular wall thickness of 20 (7) mm and GLS of -14.9 (4.5) %. Echocardiographic evaluation of diastolic dysfunction is reported in Table 1.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">CPET respiratory exchange ratio was 1.03 ±0.09 revealing adequate exercise effort, mean time of exercise was 12.4 ± 4.3 minutes. The remaining evaluated CPET parameters are reported in Table 1. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">E/e’ and peak VO2 showed an inverse correlation (correlation coefficient – 0.439, p<0.01). A correlation was also found between: E/e’ and VE/VCO2 (correlation coefficient 0.271, p=0.027); E/e’ and optimal point of ventilation (correlation coefficient 0.34, p=0.006); TDI e’ septal and pVO2 (correlation coefficient 0.37, p= 0.009); E- wave and pVO2 (correlation coefficient – 0.320, p= 0.008).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Conclusions</u> : In HCM patients, DD correlates with impaired functional capacity, with the strongest correlation found between E/e’ and pVO2. </span></span></p>
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