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Tissue Doppier derived indices predict exercise capacity in patients with apical hypertrophic cardiomyopathy

 Jong-Won Ha  ;  Jung-Rae Cho  ;  Jin-Mi Kim  ;  Jeong-Ah Ahn  ;  Eui-Young Choi  ;  Seok-Min Kang  ;  Se-Joong Rim  ;  Namsik Chung 
 CHEST, Vol.128(5) : 3428-3433, 2005 
Journal Title
Issue Date
Aged ; Aged, 80 and over ; Cardiomyopathy, Hypertrophic/blood ; Cardiomyopathy, Hypertrophic/diagnostic imaging* ; Cardiomyopathy, Hypertrophic/physiopathology* ; Exercise Test ; Exercise Tolerance* ; Female ; Ferrous Compounds ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Natriuretic Peptide, Brain/blood ; Oxygen Consumption ; Peptide Fragments/blood ; Ultrasonography, Doppler* ; Ventricular Dysfunction, Left/diagnostic imaging*
apical hypertrophic cardiomyopathy ; Doppler tissue imaging ; exercise capacity ; mitral annular velocity
BACKGROUND: Although impaired left ventricular (LV) diastolic function is a prominent feature of hypertrophic cardiomyopathy (HCM), diastolic function and its relation to exercise capacity in apical HCM (ApHCM) has not been explored previously. This study was sought to determine the relationship between diastolic mitral annular velocities combined with conventional Doppler indexes and exercise capacity in patients with ApHCM.
PATIENTS: Twenty-nine patients with ApHCM (24 men; mean age +/- SD, 57 +/- 10 years) underwent supine bicycle exercise with simultaneous respiratory gas analysis and two-dimensional and Doppler echocardiographic study.
RESULTS: The mitral inflow velocities (early filling [E], late filling, and deceleration time) were traced and measured. Early diastolic mitral annular velocity (E') was measured at the septal corner of mitral annulus by Doppler tissue imaging (DTI) from the apical four-chamber view. Pro-brain natriuretic peptide (proBNP) was measured at the time of echocardiography using a quantitative electrochemiluminescence immunoassay. E/E' ratio correlated inversely with maximal oxygen uptake (Vo(2)max) [r = - 0.47, p = 0.0106]. There was a significant positive correlation between E' and Vo(2)max (r = 0.41, p = 0.024). However, no correlation was found between conventional two-dimensional, Doppler indices, and proBNP and Vo(2)max). Of all the echocardiographic and clinical parameters assessed, E/E' ratio had the best correlation with exercise capacity (r - 0.47) and was the strongest independent predictor of Vo(2)max by multivariate analysis (p = 0.0106).
CONCLUSIONS: DTI-derived indexes (E', E/E' ratio), an estimate of myocardial relaxation and LV filling pressures, correlate with exercise capacity in patients with ApHCM, suggesting that abnormal diastolic function may be a factor limiting exercise capacity.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
Rim, Se Joong(임세중) ORCID logo https://orcid.org/0000-0002-7631-5581
Chung, Nam Sik(정남식)
Cho, Jung Rae(조정래)
Choi, Eui Young(최의영) ORCID logo https://orcid.org/0000-0003-3732-0190
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
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