Publication details

Decreased Exercise Capacity and Sleep Disordered Breathing in Patients with Hypertrophic Cardiomyopathy

Authors	KONECNY Tomas GESKE Jeffrey B. LUDKA Ondřej ORBAN Marek BRADY Peter A. ABUDIAB Muaz M. ALBUQUERQUE Felipe N. PLACEK Alexander KARA Tomas SAHAKYAN Karine R. GERSH Bernard J. TAJIK A. Jamil ALLISON Thomas G. OMMEN Steve R. SOMERS Virend K.
Year of publication	2015
Type	Article in Periodical
Magazine / Source	Chest
MU Faculty or unit	Faculty of Medicine
Citation
Web	http://journal.publications.chestnet.org/article.aspx?articleid=2107856
Doi	http://dx.doi.org/10.1378/chest.14-1498
Field	Cardiovascular diseases incl. cardiosurgery
Keywords	CARDIOPULMONARY EXERCISE; ATRIAL-FIBRILLATION; APNEA SYNDROME; TASK-FORCE; ASSOCIATION; CARDIOLOGY; DIAGNOSIS; OXIMETRY; THERAPY; PREVALENCE
Description	BACKGROUND: Mechanisms of decreased exercise capacity in patients with hypertrophic cardiomyopathy (HCM) are not well understood. Sleep-disordered breathing (SDB) is a highly prevalent but treatable disorder in patients with HCM. The role of comorbid SDB in the attenuated exercise capacity in HCM has not been studied previously. METHODS: Overnight oximetry, cardiopulmonary exercise testing, and echocardiographic studies were performed in consecutive patients with HCM seen at the Mayo Clinic. SDB was considered present if the oxygen desaturation index (number of >= 4% desaturations/h) was >= 10. Peak oxygen consumption ((V) over doto(2)peak) (the most reproducible and prognostic measure of cardiovascular fitness) was then correlated with the presence and severity of SDB. RESULTS: A total of 198 patients with HCM were studied (age, 53 +/- 16 years; 122 men), of whom 32% met the criteria for the SDB diagnosis. Patients with SDB had decreased (V) over doto(2)peak compared with those without SDB (16 mL O-2/kg/min vs 21 mL O-2/kg/min, P < .001). SDB remained significantly associated with (V) over doto(2)peak aft er accounting for confounding clinical variables (P < .001) including age, sex, BMI, atrial fibrillation, and coronary artery disease. CONCLUSIONS: In patients with HCM, the presence of SDB is associated with decreased (V) over doto(2)peak. SDB may represent an important and potentially modifiable contributor to impaired exercise tolerance in this unique population.