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Chronotropic incompetence and its relation to exercise capacity in hypertrophic cardiomyopathy
Session:
Posters (Sessão 4 - Écran 2) - Doenças do Miocárdio e Pericárdio 1
Speaker:
Isabel Cardoso
Congress:
CPC 2022
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.1 Myocardial Disease – Pathophysiology and Mechanisms
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Isabel Gonçalves Machado Cardoso; Pedro Brás; Sílvia Aguiar Rosa; Pedro Rio; José Miguel Viegas; André Grazina; Alexandra Castelo; Bárbara Teixeira; Sofia Silva; Mafalda Selas; Filipa Silva; Rui Cruz Ferreira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Introduction</u>: Compromised functional capacity is common in hypertrophic cardiomyopathy (HCM) patients (pts). Chronotropic incompetence is one of the proposed mechanisms underlying decreased functional capacity. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Aims:</u> To study the prevalence of chronotropic incompetence and its relation to exercise capacity in pts with HCM. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Methods</u>: Cardiopulmonary exercise testing was performed in 73 pts with HCM prospectively seen at an outpatient cardiomyopathy clinic. Pts with left ventricular ejection fraction <50% were excluded. Chronotropic incompetence was defined has the inability to achieve 80% or more of the predicted maximal heart rate response. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Results:</u> Of 73 pts with HCM (mean age 57 ± 14 years, 41males), 41 pts (57%) were in New York Heart Association (NYHA) functional class I, 26 (36%) in class II and 6 (7.5%) in class III. Obstructive HCM was present in 49 (69%). Chronotropic incompetence was present in 55% of pts. Treatment with β-blockers (p=0.019), female gender (p=0.035) and average mitral annulus ratio of peak early mitral inflow velocity (E) to early diastolic mitral annular velocity (e′) (E/e’ ratio) (p= 0.008) were related to chronotropic incompetence. No association was found between the presence of left ventricular outflow tract obstruction (LVOTO) and chronotropic incompetence. Regarding cardiopulmonary exercise test parameters (table 1), pts with chronotropic incompetence had lower peak oxygen consumption (peak VO2) (18.4 ± 5.3 vs 23.8 ± 6.7, p< 0.0001). </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Conclusions</u>: Diminished heart rate response to exercise is common in HCM pts and it relates to impaired functional capacity. </span></span></p>
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