Abstract 13828: Safety During Treadmill Exercise in Patients With High Gradient Hypertrophic Cardiomyopathy.
Background: Exercise echocardiography is a well established imaging modality in the evaluation of hypertrophic cardiomyopathy (HCM), providing valuable information about risk stratification, treatment options and symptoms. However, HCM patients with high left ventricular outflow gradients (LVOTG) i.e.> 30 mmHg are often excluded from exercise testing. We report the safety and clinical profile of exercise testing in 211 HCM patients with and without LVOT obstruction.
Methods: Data were abstracted from patients evaluated at the Johns Hopkins HCM clinic. All HCM patients undergo treadmill exercise testing unless excluded per following criteria: high fall risk, BP >220/120 mmHg, active angina, recent myocardial infarction, decompensated heart failure, active arrhythmias. Patients were monitored closely for symptoms and complications.
Results: The cohort was separated according to resting gradients into non-obstructive (<30 mmHg) and obstructive (>30 mmHg). The baseline characteristics of the patients are shown in table 1. Patients with obstruction were older, had higher LV mass index, slightly higher LVEF and higher gradients. Symptoms and arrhythmic events during treadmill testing are presented in table 2. Patients with obstruction had a lower work capacity and more frequently developed ECG changes. But we observed no differences in arrhythmic events. We observed no syncope or VF and all arrhythmias resolved without intervention.
Conclusion: The results of this study suggest that treadmill testing in high gradient HCM patients is safe. Given the important information the exercise test provides it should be part of the standard evaluation of all HCM patients.
- © 2011 by American Heart Association, Inc.