Prognostic relevance of exercise testing in hypertrophic cardiomyopathy. A systematic review

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:339

Review

Rodrigues, Tiago¹  Raposo, Sofia Cavaco^2,3  Brito, Dulce¹  Lopes, Luis R.^1,4,5,6 

[1] Ctr Hosp Univ Lisboa Norte, Cardiol Dept, Av Prof Egas Moniz, P-1649028 Lisbon, Portugal

[2] Univ Lisbon, Lisbon Sch Med, CAML, CCUL, Av Prof Egas Moniz, P-1649028 Lisbon 1649-028, Portugal

[3] Adm Reg Saude Lisboa & Vale Tejo, Agrp Ctr Saude Estuario Tejo, Unidade Saude Familiar Reynaldo Santos, Lisbon, Portugal

[4] Univ Lisbon, Lisbon Sch Med, Lisbon, Portugal

[5] St Bartholomews Hosp, Barts Heart Ctr, London, England

[6] St Bartholomews Hosp, Barts Heart Ctr, West Smithfield, London, England

关键词: Systematic review;    Hypertrophic cardiomyopathy;    Exercise testing;    Prognostic stratification;   

DOI  :  10.1016/j.ijcard.2021.06.051

来源: Elsevier

【 摘 要 】

Background: Cardiopulmonary exercise test (CPET) is indicated as part of the assessment in hypertrophic cardiomyopathy (HCM) patients and stress echocardiography is often used to assess symptoms. However, the role of exercise testing for prognostic stratification in HCM is still not established. Aims: To systematically review the evidence on the role of exercise testing for prognostic stratification in hypertrophic cardiomyopathy. Methods: A systematic review was conducted for eligible publications, between 2010 and 2020, that included evaluation of outcomes and prognosis. In these studies, patients underwent exercise echocardiography and/or cardiopulmonary exercise testing, performed according to predefined protocols. Diverse parameters were assessed in order to determine which were relevant for the prognosis. Analyzed outcomes included death from any cause, sudden cardiac death (SCD) and equivalents, cardiovascular death, heart failure requiring hospitalization or progression to New York Heart Association classes III or IV, cardiac transplantation, non-sustained ventricular tachycardia, stroke, myocardial infarction and invasive septal reduction therapy. Results: Eighteen publications were included, corresponding to a total of 7525 patients. The mean follow-up period varied between 1 and 8 years. The main findings of these studies revealed that the major predictors of outcomes were abnormal heart rate recovery, abnormal blood pressure response exercise induced wall motion abnormalities, lower peak VO2, higher VE/VCO2, and pulmonary hypertension/exercise-induced pulmonary hypertension. Conclusion: Although most studies concluded that exercise test results are useful to determine prognosis in HCM, further investigation is needed regarding whether it adds independent value to the current risk stratification strategies.

【 授权许可】

Free