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Department of Nuclear Medicine and The Second Department of Internal Medicine, Kanazawa University School of Medicine, Kanazawa, Japan
Correspondence: For correspondence or reprints contact: Junichi Taki, MD, Department of Nuclear Medicine, Kanazawa University School of Medicine, 13-1 Takara-machi, Kanazawa, 920, Japan.
ABSTRACT
The cardiac functional response to exercise in patients with nonobstructive hypertrophic cardiomyopathy (HCM) was evaluated using a continuous ventricular function monitor with a cadmium telluride detector (CdTe-VEST). Methods: Supine ergometric exercise was performed under CdTe-VEST monitoring in 41 patients with nonobstructive HCM (34 men and 7 women, age 18–72 yr, mean 51 yr) and 15 patients without cardiac disease (9 men and 6 women, age 36–56 yr, mean 49 yr). Results: Although 20 of 41 patients with HCM maintained a LVEF above baseline at peak exercise (Group A), 21 did not show an EF increase at peak exercise (Group B). Exercise duration and work load in Group A were longer and higher, respectively, than in Group B. Resting EF in Group B (72 ± 7.7%) was significantly higher than that in Group A (65 ± 8.2%) and the control group (62 ± 5.9%). The EF increase from baseline to EF overshoot during recovery and the time to EF overshoot were lower and longer, respectively, in Group B than in Group A and the control group. Septal wall thickness and the septum-to-posterior-wall-thickness ratio between Groups A and B were not different. ST-segment depression was observed in all 21 Group B patients and in 8 of the Group A patients. Conclusion: In patients with nonobstructive HCM, left ventricular dysfunction during exercise and during recovery was frequently observed but was not related to the degree of septal wall hypertrophy. The CdTe-VEST is a useful means to evaluate left ventricular functional reserve to exercise in patients with HCM.
Key Words: hypertrophic cardiomyopathy • continuous ventricular function monitor • VEST • exercise • left ventricular ejection fraction
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