Key result
HCM is linked to ~22% longer exercise-induced time to peak early tissue mitral velocity.
Why the study?
Hypertrophic cardiomyopathy is often associated with diastolic dysfunction that may be more markedly revealed during exercise, but current methods are not sensitive enough to detect it.
Cross-Sectional (n=84)
No
Absolute Event Rate: 355% vs 292%
p-value: p=<0.000004
May indicate impaired diastolic reserve in HCM; leaves open diagnostic utility versus hypertension.
BACKGROUND: Hypertrophic cardiomyopathy (HCM) is often associated with diastolic dysfunction. Theoretically, a more marked alteration of diastolic function is revealed during exercise. METHODS AND RESULTS: We studied 84 persons: 1) 25 patients with HCM, 2) 25 patients with essential arterial hypertension (AH) and 3) 34 healthy controls. Each person performed a treadmill echocardiography. Before and after work, the following parameters were measured: the time interval between the QRS complex and the onset of mitral early diastolic filling velocity (TE), the interval between the QRS complex and the onset of peak early tissue mitral annular velocity (Te'), the isovolumetric relaxation time over the difference of TE and Te' ratio (IVRT/(TE-Te')), and changes of the time parameters during the stress test. In comparison with hypertensive and control groups, HCM patients at rest showed a significantly longer TE (448 ± 55 vs. 423 ± 33 vs. 417 ± 24 ms, P < 0.04) and Te' (446 ± 48 vs. 403 ± 44 vs. 416 ± 38 ms, P < 0.003). After stress the HCM group had a longer Te' (355 ± 59 vs. 299 ± 40 vs. 292 ± 30 ms, P < 0.000004) and a higher IVRT/(TE-Te') ratio (3.1 ± 1.5 vs. 0.9 ± 2.4 vs. 1.7 ± 1.2, P < 0.002). CONCLUSIONS: HCM patients show an alteration in the time parameters not only compared to healthy persons but to hypertensive patients as well.
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Zagatina (2011) conducted a cross-sectional in Hypertrophic cardiomyopathy (n=84). Hypertrophic cardiomyopathy vs. Essential arterial hypertension and healthy controls was evaluated on Interval between the QRS complex and the onset of peak early tissue mitral annular velocity (Te') after exercise stress (p=<0.000004). Patients with hypertrophic cardiomyopathy exhibited a significantly longer time to peak early tissue mitral annular velocity after exercise stress (355 ms) compared to hypertensive patients (299 ms) and healthy controls (292 ms).
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