Abstract 15439: Right Ventricular Function at Rest Strongly Correlates With Cardiopulmonary Exercise Phenotype in Hypertrophic Cardiomyopathy
Background: Hypertrophic cardiomyopathy (HCM) affects the right ventricle (RV) because of the anatomically hypertrophied septum and plausibly by extension of the myopathic process to the RV. The role of RV in the functional response during exercise in hypertrophic cardiomyopathy is challenging and uninvestigated.
Purpose: To identify how and whether RV function may relate to functional capacity and especially ventilation efficiency in patients with LV hypertrophy secondary to HCM.
Methods: 24 HCM patients (mean age 60.5±14.6; male 53%; NYHA I-II-III 60-20-20%) underwent a maximal cardiopulmonary exercise testing (CPET) evaluation combined with echo-Doppler and off-line speckle tracking analysis, collecting rest and peak exercise data. We explored at the relationship between LV (left ventricle) function vs RV function at rest (detected by tricuspid annular plane systolic excursion – TASPE - and free-wall longitudinal strain) and CPET variables, using Pearson analysis to test the significance.
Results: Our population had a preserved LV ejection fraction (LVFE: mean 63.9 ± 12%), mean left ventricle end-diastolic volumes 46.3 ± 10.6 ml/mq, enlarged left atria (vol ind 52.2 ± 26.1) and preserved RV function, assessed by TAPSE (mean 22.7 ± 4.2 mm) and by free-wall strain (mean -28.7 ± 7.6%). LVEF did not show a significant correlation with CPET variables. Conversely, TAPSE and RV free-wall strain had good correlation with pressure of end-tidal CO2 (PetCO2), ventilatory efficiency (VE/VCO2 slope) and workload, as shown in the figure.
Conclusions: In HCM patients with preserved ejection fraction, RV function strongly correlates with main CPET variables, and it can seemingly be considered for predicting abnormalities in functional phenotype better than LVFE.
Author Disclosures: V. Donghi: None. F. Bandera: None. G. Generati: None. V. Tufaro: None. V. Labate: None. E. Alfonzetti: None. M. Guazzi: None.
- © 2016 by American Heart Association, Inc.