Prognostic value of systemic blood pressure response during exercise in a community-based patient population with hypertrophic cardiomyopathy
Iacopo Olivotto, MD*,
Barry J. Maron, MD, FACC ,
Alessio Montereggi, MD*,
Francesco Mazzuoli, MD*,
Alberto Dolara, MD* and
Franco Cecchi, MD*
* Cardiologia di S.Luca and Medicina Generale III, Ospedale di Careggi, Florence, Italy
Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
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Figure 1 Diagram showing systolic blood pressure (BP) and heart rate responses during exercise and the recovery phase in a severely symptomatic 16-year old girl with nonobstructive hypertrophic cardiomyopathy (patient #1 in Table 2). Systolic blood pressure failed to increase from the baseline value of 100 mm Hg, and the test was interrupted after 2 min and 30 s due to hypotension (baseline systolic blood pressure of 100 mm Hg dropping abruptly to 80 mm Hg) associated with dizziness. This patient died suddenly and unexpectedly six months after the exercise test.
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Figure 2 Cumulative survival measured from the time of the maximal symptom-limited exercise test in 89 hypertrophic cardiomyopathy patients aged  50 years. The 21 patients who demonstrated abnormal systemic blood pressure response to exercise (ABPR; broken line) showed significantly reduced survival compared with the 68 patients with a normal blood pressure (BP) response (solid line), over an average follow-up period of 4.7 ± 3.7 years.
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