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Prognostic value of reduced heart rate reserve during exercise in hypertrophic cardiomyopathy

2021Journal article Open access
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dc.contributor.authorCiampi, Quirino
dc.contributor.authorOlivotto, Iacopo
dc.contributor.authorPeteiro, Jesus
dc.contributor.authorD’Alfonso, Maria
dc.contributor.authorMori, Fabio
dc.contributor.authorTassetti, Luigi
dc.contributor.authorMilazzo, Alessandra
dc.contributor.authorMonserrat, Lorenzo
dc.contributor.authorFernandez, Xusto
dc.contributor.authorPálinkás, Attila
dc.contributor.authorPálinkás, Eszter
dc.contributor.authorSepp, Róbert
dc.contributor.authorRe, Federica
dc.contributor.authorCortigiani, Lauro
dc.contributor.authorTesic, Milorad
dc.contributor.authorDjordjevic-Dikic, Ana
dc.contributor.authorBeleslin, Branko
dc.contributor.authorLosi, Mariangela
dc.contributor.authorCanciello, Grazia
dc.contributor.authorBetocchi, Sandro
dc.contributor.authorLopes, Luis
dc.contributor.authorCruz, Ines
dc.contributor.authorCotrim, Carlos
dc.contributor.authorTorres, Marco
dc.contributor.authorBellagamba, Clarissa
dc.contributor.authorVan De Heyning, Caroline
dc.contributor.authorVarga, Albert
dc.contributor.authorÁgoston, Gergely
dc.contributor.authorVillari, Bruno
dc.contributor.authorLorenzoni, Valentina
dc.contributor.authorCarpeggiani, Clara
dc.contributor.authorPicano, Eugenio
dc.date.accessioned2021-04-27T17:43:05Z
dc.date.available2021-04-27T17:43:05Z
dc.date.issued2021
dc.description.abstractBackground: Sympathetic dysfunction can be evaluated by heart rate reserve (HRR) with exercise test. Objectives: To determine the value of HRR in predicting outcome of patients with hypertrophic cardiomyopathy (HCM). Methods: We enrolled 917 HCM patients (age = 49 +/- 15 years, 516 men) assessed with exercise stress echocardiography (ESE) in 11 centres. ESE modality was semi-supine bicycle in 51 patients (6%), upright bicycle in 476 (52%), and treadmill in 390 (42%). During ESE, we assessed left ventricular outflow tract obstruction (LVOTO), stress-induced new regional wall motion abnormalities (RWMA), and HRR (peak/rest heart rate, HR). By selection, all patients completed the follow-up. Mortality was the predetermined outcome measure Results: During ESE, RWMA occurred in 22 patients (2.4%) and LVOTO (>= 50 mmHg) in 281 (30.4%). HRR was 1.90 +/- 0.40 (lowest quartile <= 1.61, highest quartile > 2.13). Higher resting heart rate (odds ratio 1.027, 95% CI: 1.018-1.036, p < 0.001), older age (odds ratio 1.021, 95% CI: 1.009-1.033, p < 0.001), lower exercise tolerance (mets, odds ratio 0.761, 95% CI: 0.708-0.817, p < 0.001) and resting LVOTO (odds ratio 1.504, 95% CI: 1.043-2.170, p = 0.029) predicted a reduced HRR. During a median follow-up of 89 months (interquartile range: 36-145 months), 90 all-cause deaths occurred. At multivariable analysis, lowest quartile HRR (Hazard ratio 2.354, 95% CI 1.116-4.968 p = 0.025) and RWMA (Hazard ratio 3.279, 95% CI 1.441-7.461 p = 0.004) independently predicted death, in addition to age (Hazard ratio 1.064, 95% CI 1.043-1.085 p < 0.001) and maximal wall thickness (Hazard ratio 1.081, 95% CI 1.037-1.128, p < 0.001). Conclusions: A blunted HRR during ESE predicts survival independently of RWMA in HCM patients.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.3390/jcm10071347pt_PT
dc.identifier.issn2077-0383
dc.identifier.urihttp://hdl.handle.net/10400.1/15454
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherMDPIpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectAutonomic dysfunctionpt_PT
dc.subjectStress echocardiographypt_PT
dc.subjectHypertrophic cardiomyopathypt_PT
dc.titlePrognostic value of reduced heart rate reserve during exercise in hypertrophic cardiomyopathypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue7pt_PT
oaire.citation.startPage1347pt_PT
oaire.citation.titleJournal of Clinical Medicinept_PT
oaire.citation.volume10pt_PT
person.familyNameCotrim
person.givenNameCarlos
person.identifier.ciencia-id1B11-CED8-69A1
person.identifier.orcid0000-0002-4802-0831
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationdef25fde-92b5-4f4f-a790-f1ae043f8519
relation.isAuthorOfPublication.latestForDiscoverydef25fde-92b5-4f4f-a790-f1ae043f8519

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