According to a recent study by doctors at Tufts HCM Center in collaboration with colleagues in Italy, exercise testing is an invaluable tool in the assessment of hypertrophic cardiomyopathy patients.
In particular, two types of exercise testing are most valuable for HCM patients:
- Exercise Echocardiogram: These tests are valuable in determining whether a patient has obstruction. It provides a physiological way to measure whether or not a patient has an obstructed left ventricular outflow tract and hence, may potentially be in need of an invasive procedure to treat the obstruction. According to the article, approximately 1/3 of HCM patients have latent obstruction which may only be seen during or after exercise. This obstruction is not always apparent from their resting echocardiogram.
- Cardiopulmonary Exercise Testing: These tests help determine functional capacity and provide a quantifiable indicator of heart failure symptoms. This test can identify patients in need of more aggressive treatment options, or who are potentially in need of transplant. A particularly valuable piece of data from this test is the “VO2 max” score, which is a measure of the maximum rate of oxygen consumption during exercise which reflects the cardiorespiratory fitness level of a person.
*Editor’s note – Exercise testing was particularly informative and important in my own HCM treatment. It was only after my doctors performed an exercise echo that the extent of my obstruction became apparent. The symptoms I had been suffering appeared to be out of proportion to what was visualized on my resting echo. The exercise echo helped my doctors understand the cause of my symptoms which made the next step, in my case a myectomy, much clearer.
You can read my full story here .
According to research presented this week at the American Heart Association’s Scientific Sessions, the risk of dying from sudden cardiac arrest during or within 1 hour of sex is less than 1%.
The study, published by Dr. Sumeet Chugh of Cedars-Sinai Hospital in Los Angeles, looked at data collected in the Oregon Sudden Unexpected Death Study (Oregon SUDS) database between 2002 and 2015.
Dr. Chugh emphasized that survival was higher in the group of patients who received CPR, re-emphasizing the importance of teaching CPR in the general population.
For more details on this study, see these stories:
Doctors at the Cleveland Clinic recently published a study in the Journal of the American Heart Association suggesting that the measurement of left ventricular global longitudinal strain (LV-GLS), as determined by routine echocardiogram, may be helpful in determining treatment strategy for patients with obstructive HCM.
In particular, the researchers found that a poor LV-GLS measurement seemed to correlate with a higher incidence of sudden cardiac arrest and appropriate ICD discharge. Worsening LV‐GLS of less than -14% was associated with poorer prognosis, while myectomy seemed to improve LV‐GLS.
The researchers also found that a small number of HCM patients (including post-myectomy patients) with severely reduced LV‐GLS (worse than ≈ −7%) appeared to be in need of aggressive treatment, potentially including heart transplantation.
Long awaited results of the MagnaSafe study regarding the safety of MRIs in patients with implantable devices were published in February. The MagnaSafe study established a multi-center prospective registry for patients undergoing MRI scans despite their having an implanted device not deemed safe for MRI scanning by the FDA.
Continue reading “Chapter 3: MRI Safety for ICD & Pacemaker Patients”
A recent paper by doctors at Tufts University’s HCM Center found that transient episodes of atrial fibrillation (AF) are treatable and do not often progress to permanent AF.
This study found that AF was not a frequent cause of death by heart failure or sudden cardiac arrest. However, the researchers identified AF as an important cause of stroke in HCM patients. Therefore, they recommend a low threshold for starting HCM patients on anti-coagulants following an initial AF episode.
Researchers in this study analyzed statistics from 1558 HCM patients, 20% of whom experienced AF. 74% experienced only sporadic episodes, while 26% went on to develop permanent AF.
At the time of publication, 91% of the 277 of the patients included in the sample were still alive and between the ages 49 and 75 years old.
A recent study published in the European Heart Journal by doctors from the Mayo Clinic showed that women with hypertrophic cardiomyopathy (HCM) have a statistically reduced rate of survival as compared to men with HCM.
Continue reading “More is Needed for Women With HCM”
The HCM Risk–SCD Score
In 2014, the European Society of Cardiology (ESC) introduced a numerical predictor (the “HCM Risk–SCD score”) to assist physicians in identifying those patients at highest risk for sudden cardiac death who would benefit from the implantation of a prophylactic implantable cardioverter-defibrillator.
Using an algorithm generated by the answers to a series of questions, the tool estimates the 5-year risk of sudden cardiac arrest for any particular patient. You can find the tool online here.
Continue reading “A Risk Calculator for Sudden Death -Results of HCM-EVIDENCE Study”
The same Fitbit you wear to count your steps may soon have an additional purpose: it could detect atrial fibrillation.
Atrial fibrillation is an irregular heartbeat which could cause a stroke if not properly treated. Yet, it often goes unnoticed by a person experiencing it.
According to this story in Time, Fitbit is developing software which would enable its existing trackers to detect afib, and thus allow time for appropriate action before it is too late.
This technology could be of great benefit to heart patients. Not only does the Fitbit encourage you to exercise, it might just save your life!
A recent paper by researchers in Australia, published this week in Circulation: Cardiovascular Genetics, found more than one rare HCM gene in 4% of patients in a 758 patient sample group.
The researchers found that those patients with multiple rare HCM genes tended to present with HCM at a younger age, were more likely to experience cardiac arrest or death from other causes, and were more likely to require a heart transplant.
In general, few patients have multiples of mutations commonly associated with HCM. See this Canadian study from April of this year which found that multiple mutations were less prevalent and harmful than previously thought.