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The International Journal of Cardiovascular Imaging

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01-05-2019 | Echocardiography | Original Paper

Prevalence, determinants, and prognostic significance of exercise-induced pulmonary hypertension in patients with hypertrophic cardiomyopathy

Authors: Yasuhiro Hamatani, Makoto Amaki, Rika Yonezawa, Yoshiki Yanagi, Yoshito Jo, Masashi Amano, Atsushi Okada, Hiroyuki Takahama, Takuya Hasegawa, Hideaki Kanzaki, Satoshi Yasuda, Chisato Izumi

Published in: The International Journal of Cardiovascular Imaging | Issue 5/2019

Abstract

Exercise-induced pulmonary hypertension (EIPH) is associated with worse outcomes in patients with heart failure or valvular heart disease. However, little is known regarding the implications of EIPH in hypertrophic cardiomyopathy (HCM) patients. We retrospectively reviewed data of consecutive HCM patients who underwent clinically indicated exercise echocardiography using a semi-supine bicycle ergometer at our hospital. EIPH was defined as pulmonary artery systolic pressure ≥ 60 mmHg during exercise. The incidences of HCM-related mortality and HCM-related morbidity during follow-up period were evaluated. Of 42 patients (mean age 59 ± 21 years; 4 with resting obstruction, 19 with provoked obstruction, and 19 without obstruction), 16 (38%) developed EIPH. Patients with EIPH had significantly longer resting E wave deceleration time (271 ± 116 vs. 213 ± 66 ms; P = 0.04), higher resting pulmonary artery systolic pressure (35 ± 6 vs. 31 ± 5 mmHg; P = 0.04), and higher B-type natriuretic peptide level (283 [222, 465] vs. 142 [54, 423] pg/ml; P = 0.04) than those without EIPH. Kaplan–Meier curve analysis demonstrated that EIPH was significantly associated with HCM-related morbidity (log-rank; P = 0.01). In Cox regression analysis, EIPH was a significant predictor of HCM-related morbidity (hazard ratio: 5.98, 95% confidence interval 1.36–41.07; P = 0.02). In conclusion, EIPH was documented in about one-third of HCM patients. EIPH was a significant predictor of HCM-related morbidity in patients with HCM.

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Title: Prevalence, determinants, and prognostic significance of exercise-induced pulmonary hypertension in patients with hypertrophic cardiomyopathy
Authors: Yasuhiro Hamatani
Makoto Amaki
Rika Yonezawa
Yoshiki Yanagi
Yoshito Jo
Masashi Amano
Atsushi Okada
Hiroyuki Takahama
Takuya Hasegawa
Hideaki Kanzaki
Satoshi Yasuda
Chisato Izumi
Publication date: 01-05-2019
Publisher: Springer Netherlands
Keywords: Echocardiography
Cardiomyopathy
Pulmonary Hypertension
Heart Failure
Atrial Fibrillation
Echocardiography
Pulmonary Hypertension
Pulmonary Hypertension
Pulmonary Hypertension
Published in: The International Journal of Cardiovascular Imaging / Issue 5/2019
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-018-01522-4

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Prevalence, determinants, and prognostic significance of exercise-induced pulmonary hypertension in patients with hypertrophic cardiomyopathy

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