Abnormal blood pressure response during exercise in hypertrophic cardiomyopathy

Frenneaux, M P, Counihan, P J, Caforio, A L, Chikamori, T and McKenna, W J (1990) Abnormal blood pressure response during exercise in hypertrophic cardiomyopathy. Circulation, 82 (6). pp. 1995-2002. ISSN 0009-7322

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To investigate the incidence of abnormal exercise blood pressure responses in hypertrophic cardiomyopathy (HCM) and the potential role of hemodynamic instability as a mechanism of sudden death, 129 consecutive patients with HCM underwent maximal symptom-limited treadmill exercise testing with blood pressure recording. Four patterns of blood pressure response were observed. Forty-three patients had significant exercise hypotension, with either a continuous fall in systolic blood pressure (n = 5) from the start of exercise or a sudden fall in systolic blood pressure (20-100 mm Hg; mean, 40 mm Hg) from the peak value (n = 38), 23 patients had a normal response during exercise but an abnormal blood pressure response in the recovery period, and the remaining 62 patients demonstrated a normal blood pressure response. Patients with exercise hypotension were younger (33 +/- 14 versus 46 +/- 14 years) and more of them had a family history of HCM and sudden death compared with those with a normal blood pressure response (15 of 43 versus 6 of 62 patients). Similarly, the 23 patients with abnormal recovery blood pressure responses were younger (43 +/- 16 versus 46 +/- 14 years) and had a higher incidence of a family history of sudden death (10 of 24 versus 6 of 62 patients). Left ventricular cavity dimensions were smaller in those with exercise hypotension, but 11 other clinical, echocardiographic, and arrhythmic variables were similar. To assess the mechanism of exercise hypotension, 14 patients who demonstrated exercise hypotension and 14 symptomatic patients with a normal exercise blood pressure response underwent invasive hemodynamic exercise testing.(ABSTRACT TRUNCATED AT 250 WORDS)

Item Type: Article
Uncontrolled Keywords: adult,blood pressure,cardiomyopathy, hypertrophic,electrocardiography, ambulatory,exercise,exercise test,female,hemodynamics,humans,hypotension,male,middle aged,monitoring, physiologic,vascular resistance
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health
Depositing User: Pure Connector
Date Deposited: 27 Feb 2015 13:16
Last Modified: 23 Apr 2023 00:58
URI: https://ueaeprints.uea.ac.uk/id/eprint/52366
DOI: 10.1161/01.CIR.82.6.1995

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