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 .
**Because so much HCM information was presented at the Summit, this is the second of multiple blog entries. Stay tuned to HCMBeat for more highlights from the HCM Summit. To see Part I of this series of highlights from the HCM Summit VI, click here.**
The 6th International HCM Summit was held October 27, 28 and 29th in Boston, Massachusetts. This symposium brings together HCM professionals from around the world who are there to learn about and discuss the latest developments in the treatment of HCM.
The symposium was organized by long time HCM expert Dr. Barry Maron and his son, Dr. Martin Maron. Both Marons are now affiliated with Tufts Medical Center’s Hypertrophic Cardiomyopathy Center.
What follows are summaries from selected talks presented at the meeting. The presenter and their hospital affiliation are noted below, along with the topic of their presentation. When possible, you may access the presenters’ slides via hyperlink by clicking on the name. (Note that not all presenters made their slides available).
Continue reading “HIGHLIGHTS FROM THE INTERNATIONAL HCM SUMMIT VI, PART II”
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.
A study published yesterday in the Journal of the American College of Cardiology demonstrated the usefulness of computer algorithms in distinguishing hearts with HCM from athlete’s hearts on echocardiogram. The computer algorithms were able to automatically classify the echocardiographic images by distinguishing between changes seen in hypertrophic cardiomyopathy and changes seen in athletes’ hearts due to athletic conditioning.
Dr. Partho P. Sengupta, who authored the study, said that this technology may prove to be a useful tool in recognizing and diagnosing HCM for those who lack the experience to distinguish these conditions on echocardiogram.
A recent study followed 14 patients carrying one of two known genes associated with HCM (MYBPC3 and MYH7) over a 10+ year period . At the time of gene identification, none of the patients shown clinical evidence of hypertrophy. Over the time span of the study, 3 patients, who were then adults, had developed signs of HCM. Hence, the study suggests that periodic screenings are necessary for gene positive individuals throughout adulthood.
According to Cardiomyopathy U.K., the researchers undertook this project due to the lack of information and guidelines available to patients who are gene positive but have no outward signs of the disease.