Prognostic Significance of Exercise Induced Arrhythmias and Echocardiographic Variables in Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy (HC) often presents with exercise-induced symptoms, including arrhythmias and sudden death. The investigators prospectively studied whether exercise testing is associated with immediate complications and if stress-induced arrhythmias and echocardiographic variables are as...
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| Veröffentlicht in: | The American journal of cardiology 2007-03, Vol.99 (6), p.835-838 |
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| creator | Bunch, T. Jared, MD Chandrasekaran, Krishnaswamy, MD Ehrsam, Jo-Ellen, RDCS Hammill, Stephen C., MD Urban, Lynn H., BS Hodge, David O., MS Ommen, Steve R., MD Pellikka, Patricia A., MD |
| description | Hypertrophic cardiomyopathy (HC) often presents with exercise-induced symptoms, including arrhythmias and sudden death. The investigators prospectively studied whether exercise testing is associated with immediate complications and if stress-induced arrhythmias and echocardiographic variables are associated with long-term adverse outcomes. Exercise echocardiography with 6-channel continuous monitoring for arrhythmias was performed in consecutive patients with HC clinically referred for the test. End points included death, myocardial infarction, revascularization, stroke, atrial fibrillation, ventricular tachycardia, and myectomy. Of 86 patients with HC (mean age 56.6 ± 16.1 years) who underwent exercise echocardiography, arrhythmias occurred in 39 (45%), including 23 (27%) with premature atrial contractions, 2 (2%) with atrial fibrillation, 28 (33%) with premature ventricular contractions (16 also had atrial arrhythmias), and 1 (1.2%) with nonsustained ventricular tachycardia (hemodynamically stable). During a follow-up of 2.6 ± 2.8 years, major events occurred in 11 patients (3 deaths, 5 revascularizations, 3 strokes). In addition, 12 patients developed atrial fibrillation, 6 developed nonsustained ventricular tachycardia, and 13 underwent myectomies. Variables associated with major events included hypertension, male gender, and worsening wall motion score index with exercise; increased exercise duration was associated with fewer events. ST-T changes on baseline electrocardiography and premature ventricular contractions were associated with atrial fibrillation risk. In conclusion, in this cohort of patients with HC, exercise testing was safe. Test results were associated with risk for adverse events. |
| doi_str_mv | 10.1016/j.amjcard.2006.10.046 |
| format | Article |
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Jared, MD ; Chandrasekaran, Krishnaswamy, MD ; Ehrsam, Jo-Ellen, RDCS ; Hammill, Stephen C., MD ; Urban, Lynn H., BS ; Hodge, David O., MS ; Ommen, Steve R., MD ; Pellikka, Patricia A., MD</creator><creatorcontrib>Bunch, T. Jared, MD ; Chandrasekaran, Krishnaswamy, MD ; Ehrsam, Jo-Ellen, RDCS ; Hammill, Stephen C., MD ; Urban, Lynn H., BS ; Hodge, David O., MS ; Ommen, Steve R., MD ; Pellikka, Patricia A., MD</creatorcontrib><description>Hypertrophic cardiomyopathy (HC) often presents with exercise-induced symptoms, including arrhythmias and sudden death. The investigators prospectively studied whether exercise testing is associated with immediate complications and if stress-induced arrhythmias and echocardiographic variables are associated with long-term adverse outcomes. Exercise echocardiography with 6-channel continuous monitoring for arrhythmias was performed in consecutive patients with HC clinically referred for the test. End points included death, myocardial infarction, revascularization, stroke, atrial fibrillation, ventricular tachycardia, and myectomy. Of 86 patients with HC (mean age 56.6 ± 16.1 years) who underwent exercise echocardiography, arrhythmias occurred in 39 (45%), including 23 (27%) with premature atrial contractions, 2 (2%) with atrial fibrillation, 28 (33%) with premature ventricular contractions (16 also had atrial arrhythmias), and 1 (1.2%) with nonsustained ventricular tachycardia (hemodynamically stable). During a follow-up of 2.6 ± 2.8 years, major events occurred in 11 patients (3 deaths, 5 revascularizations, 3 strokes). In addition, 12 patients developed atrial fibrillation, 6 developed nonsustained ventricular tachycardia, and 13 underwent myectomies. Variables associated with major events included hypertension, male gender, and worsening wall motion score index with exercise; increased exercise duration was associated with fewer events. ST-T changes on baseline electrocardiography and premature ventricular contractions were associated with atrial fibrillation risk. In conclusion, in this cohort of patients with HC, exercise testing was safe. Test results were associated with risk for adverse events.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2006.10.046</identifier><identifier>PMID: 17350377</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Arrhythmias, Cardiac - diagnosis ; Arrhythmias, Cardiac - diagnostic imaging ; Arrhythmias, Cardiac - physiopathology ; Biological and medical sciences ; Cardiac arrhythmia ; Cardiac dysrhythmias ; Cardiology ; Cardiology. Vascular system ; Cardiomyopathy, Hypertrophic - diagnosis ; Cardiomyopathy, Hypertrophic - diagnostic imaging ; Cardiomyopathy, Hypertrophic - epidemiology ; Cardiomyopathy, Hypertrophic - physiopathology ; Cardiovascular ; Cardiovascular disease ; Cardiovascular system ; Child ; Cohort Studies ; Correlation analysis ; Diagnostic tests ; Echocardiography ; Exercise ; Exercise Test ; Female ; Heart ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical prognosis ; Medical sciences ; Middle Aged ; Minnesota - epidemiology ; Myocarditis. Cardiomyopathies ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Risk Factors ; Stress ; Ultrasonic imaging ; Ultrasonic investigative techniques</subject><ispartof>The American journal of cardiology, 2007-03, Vol.99 (6), p.835-838</ispartof><rights>Elsevier Inc.</rights><rights>2007 Elsevier Inc.</rights><rights>2007 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. 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Jared, MD</creatorcontrib><creatorcontrib>Chandrasekaran, Krishnaswamy, MD</creatorcontrib><creatorcontrib>Ehrsam, Jo-Ellen, RDCS</creatorcontrib><creatorcontrib>Hammill, Stephen C., MD</creatorcontrib><creatorcontrib>Urban, Lynn H., BS</creatorcontrib><creatorcontrib>Hodge, David O., MS</creatorcontrib><creatorcontrib>Ommen, Steve R., MD</creatorcontrib><creatorcontrib>Pellikka, Patricia A., MD</creatorcontrib><title>Prognostic Significance of Exercise Induced Arrhythmias and Echocardiographic Variables in Hypertrophic Cardiomyopathy</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Hypertrophic cardiomyopathy (HC) often presents with exercise-induced symptoms, including arrhythmias and sudden death. The investigators prospectively studied whether exercise testing is associated with immediate complications and if stress-induced arrhythmias and echocardiographic variables are associated with long-term adverse outcomes. Exercise echocardiography with 6-channel continuous monitoring for arrhythmias was performed in consecutive patients with HC clinically referred for the test. End points included death, myocardial infarction, revascularization, stroke, atrial fibrillation, ventricular tachycardia, and myectomy. Of 86 patients with HC (mean age 56.6 ± 16.1 years) who underwent exercise echocardiography, arrhythmias occurred in 39 (45%), including 23 (27%) with premature atrial contractions, 2 (2%) with atrial fibrillation, 28 (33%) with premature ventricular contractions (16 also had atrial arrhythmias), and 1 (1.2%) with nonsustained ventricular tachycardia (hemodynamically stable). During a follow-up of 2.6 ± 2.8 years, major events occurred in 11 patients (3 deaths, 5 revascularizations, 3 strokes). In addition, 12 patients developed atrial fibrillation, 6 developed nonsustained ventricular tachycardia, and 13 underwent myectomies. Variables associated with major events included hypertension, male gender, and worsening wall motion score index with exercise; increased exercise duration was associated with fewer events. ST-T changes on baseline electrocardiography and premature ventricular contractions were associated with atrial fibrillation risk. In conclusion, in this cohort of patients with HC, exercise testing was safe. Test results were associated with risk for adverse events.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arrhythmias, Cardiac - diagnosis</subject><subject>Arrhythmias, Cardiac - diagnostic imaging</subject><subject>Arrhythmias, Cardiac - physiopathology</subject><subject>Biological and medical sciences</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiology</subject><subject>Cardiology. 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Cardiomyopathies</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Stress</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonic investigative techniques</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFklFr1TAUx4Mo7jr9CEoR9K3XJG2a9EUZl6sbDBSmvobTJL1NbZu7pB3225vuFgd72VNI8sufnPM7CL0leEswKT61W-hbBV5vKcZFPNvivHiGNkTwMiUlyZ6jDcaYpiXJyzP0KoQ2bglhxUt0RnjGcMb5Bt398O4wuDBaldzYw2Brq2BQJnF1sv9rvLLBJFeDnpTRyYX3zTw2vYWQwKCTvWrc8gXrDh6OTYz4Dd5C1ZmQ2CG5nI_Gj97d3-zuuX52Rxib-TV6UUMXzJt1PUe_vu5_7i7T6-_frnYX16linI4p0zojolQCQy6qiolal1zUnFeM53WJha4IQFZQAK0BYnFCl4xqTRXB3BTZOfp4yj16dzuZMMreBmW6DgbjpiA5pjnLKHkSpDgXggkcwfePwNZNfohFSJrFnkY5eYTYCVLeheBNLY_e9uBnSbBc9MlWrvrkom85jvriu3dr-FT1Rj-8Wn1F4MMKQFDQ1T66suGBiy0RlC1BX06cic29s8bLoKyJXrX1Ro1SO_vkVz4_SlCdHeJwdH_MbML_ookMVGJ5s8zaMmq4wDQrhcj-ARp_0Vk</recordid><startdate>20070315</startdate><enddate>20070315</enddate><creator>Bunch, T. 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Vascular system</topic><topic>Cardiomyopathy, Hypertrophic - diagnosis</topic><topic>Cardiomyopathy, Hypertrophic - diagnostic imaging</topic><topic>Cardiomyopathy, Hypertrophic - epidemiology</topic><topic>Cardiomyopathy, Hypertrophic - physiopathology</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular system</topic><topic>Child</topic><topic>Cohort Studies</topic><topic>Correlation analysis</topic><topic>Diagnostic tests</topic><topic>Echocardiography</topic><topic>Exercise</topic><topic>Exercise Test</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Minnesota - epidemiology</topic><topic>Myocarditis. 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Jared, MD</au><au>Chandrasekaran, Krishnaswamy, MD</au><au>Ehrsam, Jo-Ellen, RDCS</au><au>Hammill, Stephen C., MD</au><au>Urban, Lynn H., BS</au><au>Hodge, David O., MS</au><au>Ommen, Steve R., MD</au><au>Pellikka, Patricia A., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Significance of Exercise Induced Arrhythmias and Echocardiographic Variables in Hypertrophic Cardiomyopathy</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2007-03-15</date><risdate>2007</risdate><volume>99</volume><issue>6</issue><spage>835</spage><epage>838</epage><pages>835-838</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Hypertrophic cardiomyopathy (HC) often presents with exercise-induced symptoms, including arrhythmias and sudden death. The investigators prospectively studied whether exercise testing is associated with immediate complications and if stress-induced arrhythmias and echocardiographic variables are associated with long-term adverse outcomes. Exercise echocardiography with 6-channel continuous monitoring for arrhythmias was performed in consecutive patients with HC clinically referred for the test. End points included death, myocardial infarction, revascularization, stroke, atrial fibrillation, ventricular tachycardia, and myectomy. Of 86 patients with HC (mean age 56.6 ± 16.1 years) who underwent exercise echocardiography, arrhythmias occurred in 39 (45%), including 23 (27%) with premature atrial contractions, 2 (2%) with atrial fibrillation, 28 (33%) with premature ventricular contractions (16 also had atrial arrhythmias), and 1 (1.2%) with nonsustained ventricular tachycardia (hemodynamically stable). During a follow-up of 2.6 ± 2.8 years, major events occurred in 11 patients (3 deaths, 5 revascularizations, 3 strokes). In addition, 12 patients developed atrial fibrillation, 6 developed nonsustained ventricular tachycardia, and 13 underwent myectomies. Variables associated with major events included hypertension, male gender, and worsening wall motion score index with exercise; increased exercise duration was associated with fewer events. ST-T changes on baseline electrocardiography and premature ventricular contractions were associated with atrial fibrillation risk. In conclusion, in this cohort of patients with HC, exercise testing was safe. Test results were associated with risk for adverse events.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>17350377</pmid><doi>10.1016/j.amjcard.2006.10.046</doi><tpages>4</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Arrhythmias, Cardiac - diagnosis Arrhythmias, Cardiac - diagnostic imaging Arrhythmias, Cardiac - physiopathology Biological and medical sciences Cardiac arrhythmia Cardiac dysrhythmias Cardiology Cardiology. Vascular system Cardiomyopathy, Hypertrophic - diagnosis Cardiomyopathy, Hypertrophic - diagnostic imaging Cardiomyopathy, Hypertrophic - epidemiology Cardiomyopathy, Hypertrophic - physiopathology Cardiovascular Cardiovascular disease Cardiovascular system Child Cohort Studies Correlation analysis Diagnostic tests Echocardiography Exercise Exercise Test Female Heart Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical prognosis Medical sciences Middle Aged Minnesota - epidemiology Myocarditis. Cardiomyopathies Predictive Value of Tests Prognosis Prospective Studies Risk Factors Stress Ultrasonic imaging Ultrasonic investigative techniques |
| title | Prognostic Significance of Exercise Induced Arrhythmias and Echocardiographic Variables in Hypertrophic Cardiomyopathy |
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