Left ventricular systolic dysfunction during exercise and dobutamine stress in patients with hypertrophic cardiomyopathy

摘要: OBJECTIVES We sought to characterize stress-induced left ventricular systolic dysfunction in patients with hypertrophic cardiomyopathy (HCM). BACKGROUND Myocardial ischemia and diastolic occur HCM. hypothesized that, the setting of transient myocardial ischemia, occurs during exercise dobutamine stress. METHODS studied 39 HCM but without obstructive symptoms at rest or coronary artery disease. A continuous function monitor equipped cadmium telluride detectors (VEST) was used evaluate supine bicycle ergometer exercise. Dobutamine stress echocardiography (DSE) also performed. The ejection fraction (LVEF) regional wall motion were determined from echocardiographic images. RESULTS Changes LVEF correlated between (r = 0.643, p < 0.0001). decreased more than 5% peak 17 (group II), while other had normal responses I). New abnormalities infusion detected 18 110 (16.4%) segments group I 42 85 (49.4%) II. Decreased unchanged occurred frequently hypertrophied nonhypertrophied (p There significant inverse correlations both stresses number abnormal noted all (VEST: 0.005; DSE: 0.0005). Signs obstruction observed 11 DSE. However, there no correlation response dobutamine-induced pressure gradient. CONCLUSIONS Exercise-induced 50% In these patients, present segments.