Exercise and myocardial injury in hypertrophic cardiomyopathy
| العنوان: | Exercise and myocardial injury in hypertrophic cardiomyopathy |
|---|---|
| المؤلفون: | G. Etienne Cramer, Marcel J.M. Kofflard, Menko-Jan de Boer, D.H. Frank Gommans, Marc A. Brouwer, Michelle Michels, Michael A. Fouraux, Jeannette Bakker, Hendrik-Jan Dieker, Freek W.A. Verheugt, Janneke Timmermans |
| المساهمون: | Cardiology |
| المصدر: | Heart, 106(15), 1169-1175. BMJ Publishing Group Heart, 106, 15, pp. 1169-75 Heart, 106, 1169-75 Heart |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Male, Time Factors, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], 030204 cardiovascular system & hematology, Muscle hypertrophy, 0302 clinical medicine, High oxygen, Risk Factors, Active disease, 030212 general & internal medicine, Prospective Studies, Netherlands, medicine.diagnostic_test, biology, Hypertrophic cardiomyopathy, Middle Aged, Prognosis, Up-Regulation, Cardiology, Female, Cardiology and Cardiovascular Medicine, Adult, medicine.medical_specialty, Magnetic Resonance Imaging, Cine, macromolecular substances, exercise, CMR, Risk Assessment, 03 medical and health sciences, Troponin T, Predictive Value of Tests, Internal medicine, cardiac troponin, medicine, Late gadolinium enhancement, Humans, In patient, Heart Failure and Cardiomyopathies, Aged, business.industry, Myocardium, Magnetic resonance imaging, Cardiomyopathy, Hypertrophic, medicine.disease, hypertrophic cardiomyopathy, Troponin, Bicycling, Case-Control Studies, biology.protein, Exercise Test, business, Biomarkers |
| الوصف: | ObjectiveTroponin and high signal intensity on T2-weighted (HighT2) cardiovascular magnetic resonance imaging (CMRi) are both markers of myocardial injury in hypertrophic cardiomyopathy (HCM). The interplay between exercise and disease development remains uncertain in HCM. We sought to assess the occurrence of postexercise troponin rises and its determinants.MethodsMulticentre project on patients with HCM and mutation carriers without hypertrophy (controls). Participants performed a symptom limited bicycle test with hs-cTnT assessment pre-exercise and 6 hours postexercise. Pre-exercise CMRi was performed in patients with HCM to assess measures of hypertrophy and myocardial injury. Depending on baseline troponin (< or >13 ng/L), a rise was defined as a >50% or >20% increase, respectively.ResultsTroponin rises occurred in 18% (23/127) of patients with HCM and 4% (2/53) in mutation carriers (p=0.01). Comparing patients with HCM with and without a postexercise troponin rise, maximum heart rates (157±19 vs 143±23, p=0.004) and maximal wall thickness (20 mm vs 17 mm, p=0.023) were higher in the former, as was the presence of late gadolinium enhancement (85% vs 57%, p=0.02). HighT2 was seen in 65% (13/20) and 19% (15/79), respectively (pConclusionsPostexercise troponin rises were seen in about 20% of patients with HCM, almost five times more frequent than in mutation carriers. HighT2 on CMRi may identify a group of particularly vulnerable patients, supporting the concept that HighT2 reflects an active disease state, prone to additional injury after a short episode of high oxygen demand. |
| وصف الملف: | application/pdf |
| تدمد: | 1355-6037 |
| DOI: | 10.1136/heartjnl-2019-315818 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c50a4f88bd925ebe9eeb6f3336a79453 https://doi.org/10.1136/heartjnl-2019-315818 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....c50a4f88bd925ebe9eeb6f3336a79453 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 13556037 |
|---|---|
| DOI: | 10.1136/heartjnl-2019-315818 |