Biphasic changes in left ventricular end-diastolic pressure during dynamic exercise in patients with nonobstructive hypertrophic cardiomyopathy.
J Am Coll Cardiol
; 38(2): 335-43, 2001 Aug.
Article
en En
| MEDLINE
| ID: mdl-11499721
ABSTRACT
OBJECTIVES:
The aim of this study was to clarify the serial changes in left ventricular (LV) end-diastolic pressure (LVEDP) during dynamic exercise in patients with hypertrophic cardiomyopathy (HCM).BACKGROUND:
Although HCM is characterized by impaired resting LV diastolic function, serial changes in LVEDP during exercise have not been characterized.METHODS:
We simultaneously measured LV pressure and LV dimensions during symptom-limited supine bicycle exercise in 5 healthy individuals and 20 patients with HCM. Exercise thallium-201 scintigraphic studies were also performed.RESULTS:
The LVEDP (baseline 12 +/- 5 mm Hg) progressively increased to a maximum value at peak exercise (28 +/- 8 mm Hg) in 11 patients with HCM (group I). In the remaining nine patients with HCM (group II), changes in LVEDP during exercise were biphasic, with an initial progressive increase and a subsequent gradual decline up to peak exercise (14 +/- 4 mm Hg at baseline, 27 +/- 5 mm Hg at the critical heart rate, 16 +/- 3 mm Hg at peak exercise). Exercise-induced changes in LV dimensions and LV peak systolic pressures were similar in both groups. However, the maximum first derivative of LV pressure was greater and the LV pressure half-time was shorter in group II than in group I at a similar peak exercise heart rate. The biphasic changes in LVEDP disappeared by pretreatment with propranolol. The LV hypertrophy scores were higher in group I than in group II. Exercise thallium-201 images showed more severe perfusion defects in group I than in group II patients.CONCLUSIONS:
The biphasic changes in LVEDP seen during exercise may be related to improved coronary microcirculation in response to beta-adrenergic stimulation in patients with mild to moderate HCM.
Buscar en Google
Banco de datos:
MEDLINE
Asunto principal:
Cardiomiopatía Hipertrófica
/
Ejercicio Físico
/
Presión Ventricular
/
Disfunción Ventricular Izquierda
Tipo de estudio:
Diagnostic_studies
Límite:
Adult
/
Aged
/
Humans
/
Middle aged
Idioma:
En
Revista:
J Am Coll Cardiol
Año:
2001
Tipo del documento:
Article
País de afiliación:
Japón