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Hemodynamic determinants of exercise-induced abnormal blood pressure response in hypertrophic cardiomyopathy

Quirino Ciampi, MD^*, Sandro Betocchi, MD, FACC^*,*, Raffaella Lombardi, MD^*, Fiore Manganelli, MD^*, Giovanni Storto, MD, Maria Angela Losi, MD^*, Elpidio Pezzella, MD^*, Filippo Finizio, MD^*, Alberto Cuocolo, MD and Massimo Chiariello, MD, FACC^*

^* Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Naples, Italy
Department of Morphological and Functional Sciences, "Federico II" University School of Medicine, Naples, Italy

View larger version (16K): [in a new window]   Figure 1 Mean value ± SEM of ejection fraction (%) measured at baseline, 3 min and peak exercise in the two study groups (squares = control subjects; diamonds = patients with hypertrophic cardiomyopathy [HCM]). The p value reflects two-way analysis of variance for repeated measures. *p < 0.001 vs. patients with HCM, as tested by post-hoc analysis.

View larger version (14K): [in a new window]   Figure 2 Mean value ± 1 SEM of percent difference in stroke volume (%) between peak exercise and baseline in the two study groups: control subjects and patients with hypertrophic cardiomyopathy (HCM).

View larger version (17K): [in a new window]   Figure 3 Mean value ± 1 SEM of systemic vascular resistance (%) measured at baseline, 3 min and peak exercise in the two study groups (squares = control subjects; diamonds = patients with hypertrophic cardiomyopathy). The p value reflects two-way analysis of variance for repeated measures.

View larger version (12K): [in a new window]   Figure 4 Mean value ± SEM of ejection fraction (%) measured at baseline, 3 min and peak exercise in the two study groups (squares = patients with hypertrophic cardiomyopathy [HCM] and a normal systolic blood pressure [BP] response to exercise; diamonds = patients with HCM and an abnormal systolic BP response to exercise). The p value reflects two-way analysis of variance for repeated measures. *p = 0.003 vs. HCM abnormal response, as tested by post-hoc analysis.

View larger version (13K): [in a new window]   Figure 5 Mean value ± SEM of percent difference in stroke volume (%) between peak exercise and baseline in the two study groups: patients with hypertrophic cardiomyopathy (HCM) and a normal systolic blood pressure (BP) response to exercise and patients with HCM and an abnormal systolic BP response to exercise.

View larger version (18K): [in a new window]   Figure 6 Mean value ± SEM of systemic vascular resistance (%) measured at baseline, 3 min and peak exercise in the two study groups (squares = patients with hypertrophic cardiomyopathy [HCM] and a normal systolic blood pressure [BP] response to exercise; diamonds = patients with HCM and an abnormal systolic BP response to exercise). The p value reflects two-way analysis of variance for repeated measures.