TY - JOUR
T1 - Relationship between baseline resting diastolic function and exercise capacity in patients with hypertrophic cardiomyopathy undergoing treadmill stress echocardiography
T2 - A cohort study
AU - AlJaroudi, Wael A.
AU - Desai, Milind Y.
AU - Alraies, M. Chadi
AU - Thamilarasan, Maran
AU - Menon, Venu
AU - Rodriguez, L. Leonardo
AU - Smedira, Nicholas
AU - Grimm, Richard A.
AU - Lever, Harry M.
AU - Jaber, Wael A.
PY - 2012
Y1 - 2012
N2 - Objective: Diastolic dysfunction (DD) is often incriminated in the symptomatology of patients with hypertrophic cardiomyopathy (HCM), but with limited supporting data. This study sought to assess the relationship between baseline diastolic function and exercise capacity in patients with HCM. Design: Retrospective study. Setting: Tertiary referral centre from Cleveland, Ohio, USA. Participants: 695 consecutive patients with a diagnosis of HCM who underwent exercise stress echocardiography between 1996 and 2011. Primary and secondary outcome measures: Diastolic function was reassessed from the resting echocardiograms by two blinded board-certified cardiologists. Maximal metabolic equivalents (MET) were extracted from the records. Multivariate regression analysis was performed to determine independent predictors of METs achieved. Results: Of 695 patients, 130 were excluded because of inability to assess diastolic function. There was no significant difference in maximal METs achieved between those excluded and included in the analysis (p=0.80). There were 495 remaining patients with a mean age (SD) of 50 (15) years, and 32% women among whom 102 (21%) had normal diastolic function, 243 (49%) stage 1 DD; 131 (26%) stage 2 DD and 19 (4%) stage 3 DD. Patients with advanced DD had lower maximal METs achieved compared with those with normal diastolic function (OR 3.18(1.96 to 5.14) for stage 1 versus normal, and 3.21(1.89 to 5.43) for stage ≥2 versus normal, p<0.0001 for both). After adjustment for demographics, comorbidities, echocardiographic parameters and haemodynamics, baseline DD was not an independent predictor of maximal METs achieved. Conclusions: Although baseline DD is common in patients with HCM, it does not predict maximal METs achieved beyond traditional risk factors.
AB - Objective: Diastolic dysfunction (DD) is often incriminated in the symptomatology of patients with hypertrophic cardiomyopathy (HCM), but with limited supporting data. This study sought to assess the relationship between baseline diastolic function and exercise capacity in patients with HCM. Design: Retrospective study. Setting: Tertiary referral centre from Cleveland, Ohio, USA. Participants: 695 consecutive patients with a diagnosis of HCM who underwent exercise stress echocardiography between 1996 and 2011. Primary and secondary outcome measures: Diastolic function was reassessed from the resting echocardiograms by two blinded board-certified cardiologists. Maximal metabolic equivalents (MET) were extracted from the records. Multivariate regression analysis was performed to determine independent predictors of METs achieved. Results: Of 695 patients, 130 were excluded because of inability to assess diastolic function. There was no significant difference in maximal METs achieved between those excluded and included in the analysis (p=0.80). There were 495 remaining patients with a mean age (SD) of 50 (15) years, and 32% women among whom 102 (21%) had normal diastolic function, 243 (49%) stage 1 DD; 131 (26%) stage 2 DD and 19 (4%) stage 3 DD. Patients with advanced DD had lower maximal METs achieved compared with those with normal diastolic function (OR 3.18(1.96 to 5.14) for stage 1 versus normal, and 3.21(1.89 to 5.43) for stage ≥2 versus normal, p<0.0001 for both). After adjustment for demographics, comorbidities, echocardiographic parameters and haemodynamics, baseline DD was not an independent predictor of maximal METs achieved. Conclusions: Although baseline DD is common in patients with HCM, it does not predict maximal METs achieved beyond traditional risk factors.
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U2 - 10.1136/bmjopen-2012-002104
DO - 10.1136/bmjopen-2012-002104
M3 - Article
C2 - 23242244
AN - SCOPUS:84873861535
SN - 2044-6055
VL - 2
JO - BMJ Open
JF - BMJ Open
IS - 6
M1 - e002104
ER -