Chronotropic incompetence and its relation to exercise intolerance in hypertrophic cardiomyopathy
International Journal of CardiologyPublished 21 September 2010
Georgios Efthimiadis, Georgios Giannakoulas, Despina Parcharidou, Efstathios D. Pagourelias, Evangelia Kouidi, Georgios Spanos
Citations56
SJR quartileQ1
SJR score1.13
SNIP0.96
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Blunted heart rate response to exercise is common in HCM and represents an important determinant of exercise capacity.
Abstract
Blunted heart rate response to exercise is common in HCM and represents an important determinant of exercise capacity.
Keywords
Medicine
CirculationRecommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements.
7,475 Citations1978David J. Sahn, A N Demaria +2 more
International Journal of CardiologyEthical authorship and publishing
2,143 Citations2008Andrew J.S. Coats
Principles of Ethical Publishing in the International Journal of Cardiology: that the corresponding author has the approval of all other listed authors for the submission and publication of all versions of the manuscript.
Hypertrophic Cardiomyopathy
1,773 Citations1982Young Hypertensive, Kenneth Chin
Cardiovascular magnetic resonance (CMR) can reliably identify areas of increased LV wall thickness, as well as detailed characterization of myocardial structures such as the papillary muscles and mitral valve, with implications on management strategies.
New England Journal of MedicineHeart-Rate Profile during Exercise as a Predictor of Sudden Death
1,007 Citations2005Xavier Jouven, Jean‐Philippe Empana +4 more
New England Journal of MedicineHypertrophic Cardiomyopathy
900 Citations1987Barry J. Maron, Robert O. Bonow +3 more
Seconde partie d'une revue: interrelations entre mecanismes physiopathologiques et manifestations cliniques; traitement medical ; traitement chirurgical.
CirculationExercise Intolerance in Adult Congenital Heart Disease
878 Citations2005Gerhard‐Paul Diller, Konstantinos Dimopoulos +10 more
Exercise capacity is depressed in ACHD patients (even in allegedly asymptomatic patients) on a par with chronic heart failure subjects and is related to the frequency and duration of hospitalization.
CirculationImpaired Chronotropic and Vasodilator Reserves Limit Exercise Capacity in Patients With Heart Failure and a Preserved Ejection Fraction
690 Citations2006Barry A. Borlaug, Vojtěch Melenovský +5 more
HFpEF patients have reduced chronotropic, vasodilator, and cardiac output reserve during exercise compared with matched subjects with hypertensive cardiac hypertrophy and may provide novel therapeutic targets for interventions to improve exercise capacity in this disorder.
JAMAImpaired Chronotropic Response to Exercise Stress Testing as a Predictor of Mortality
623 Citations1999Michael S. Lauer
Among patients with known or suspected coronary disease, chronotropic incompetence is independently predictive of all-cause mortality, even after considering thallium perfusion defects.
CirculationImpaired Heart Rate Response to Graded Exercise
531 Citations1996Michael S. Lauer, Peter M. Okin +3 more
An attenuated heart rate response to exercise, a manifestation of chronotropic incompetence, is predictive of increased mortality and coronary heart disease incidence.
CirculationAssessment of Permanent Dual-Chamber Pacing as a Treatment for Drug-Refractory Symptomatic Patients With Obstructive Hypertrophic Cardiomyopathy
498 Citations1999Barry J. Maron, Rick A. Nishimura +4 more
CirculationImpaired chronotropic response to exercise in patients with congestive heart failure. Role of postsynaptic beta-adrenergic desensitization.
374 Citations1989Wilson S. Colucci, Jorge P. Ribeiro +6 more
The data strongly suggest that the attenuated HR response to exercise in CHF patients is due, at least in part, to postsynaptic desensitization of the beta-adrenergic receptor pathway.
Journal of the American College of CardiologyMyocardial ischemia detected by thallium scintigraphy is frequently related to cardiac arrest and syncope in young patients with hypertrophic cardiomyopathy
278 Citations1993Vasken Dilsizian, Robert O. Bonow +2 more
It is suggested that in young patients with hypertrophic cardiomyopathy, sudden cardiac arrest or syncope is frequently related to ischemia rather than to a primary arrhythmogenic ventricular substrate.
Journal of Clinical InvestigationSkeletal muscle expression and abnormal function of beta-myosin in hypertrophic cardiomyopathy.
241 Citations1993Giovanni Cuda, Lameh Fananapazir +3 more
Mutant beta-myosin, also shown to be present in skeletal muscle by Western blot analysis, translocated actin filaments slower than normal controls in an in vitro motility assay, confirming the primary role of missense mutations in beta-MHC gene in the etiology of hypertrophic cardiomyopathy.
Journal of the American College of CardiologyHeart Rate Response During Exercise Predicts Survival in Adults With Congenital Heart Disease
239 Citations2006Gerhard‐Paul Diller, Konstantinos Dimopoulos +9 more
An abnormal heart rate response to exercise identifies ACHD patients with a higher risk of mortality in the midterm, even after accounting for antiarrhythmic medication and exercise capacity.
CirculationElectrophysiologic abnormalities in patients with hypertrophic cardiomyopathy. A consecutive analysis in 155 patients.
203 Citations1989Lameh Fananapazir, Cynthia M. Tracy +6 more
Multivariate logistic regression analysis revealed that the following were significantly associated with inducibility of sustained ventricular arrhythmia: clinical presentation and clinical presentation in patients with a history of cardiac arrest or syncope and patients with presyncope or asymptomatic patients.
CirculationExercise Capacity in Hypertrophic Cardiomyopathy
179 Citations1995Suhas S. Lele, H. Thomson +4 more
Circulation ResearchMyocardial Presynaptic and Postsynaptic Autonomic Dysfunction in Hypertrophic Cardiomyopathy
176 Citations1998Michael Schäfers, David P. Dutka +5 more
The hypothesis that myocardial betaAR downregulation in HCM is associated with an impaired uptake-1 mechanism and hence increased local catecholamine levels is tested.
Journal of ElectrophysiologyA Mathematical Model of the Cardiac Chronotropic Response to Exercise
166 Citations1989Bruce L. Wilkoff, Joseph M. Corey +1 more
It is concluded that the cardiac chronotropic response can be modeled as a simple linear mathematical function of exercise intensity, age, resting heart rate, and maximal functional capacity, and is independent of type of treadmill exercise protocol in normal subjects.
The American Journal of CardiologyUtility of cardiopulmonary exercise in the assessment of clinical determinants of functional capacity in hypertrophic cardiomyopathy
131 Citations2000Sanjay Sharma, Perry Elliott +5 more
The data indicate that mechanical obstruction has an adverse pathophysiologic effect on functional capacity and provide the rationale to support treatments aimed at gradient reduction and peak VO(2) is a superior measure of cardiovascular performance in individual patients.
European Journal of RadiologyComparison of different quantification methods of late gadolinium enhancement in patients with hypertrophic cardiomyopathy
114 Citations2009Mateusz Śpiewak, Łukasz A. Małek +8 more
LGE quantification with the use of a threshold of 6SD above the mean SI of the remote myocardium provided the best agreement with visual assessment in patients with HCM.
CirculationThe effect of hypertension and left ventricular hypertrophy on the lower range of coronary autoregulation.
105 Citations1988David G. Harrison, Michael S. Florentine +3 more
These studies were performed to test the hypothesis that left ventricular hypertrophy arising as a complication of chronic hypertension is associated with impaired coronary autoregulation and in normal dogs, reduction of circumflex pressure did not alter total myocardial perfusion or the transmural distribution of perfusion.
HeartCardiopulmonary responses to exercise in patients with hypertrophic cardiomyopathy
88 Citations1998S. Jones, Perry Elliott +3 more
There were severe abnormalities in maximal and submaximal indices of pulmonary gas exchange in a cohort of hypertrophic cardiomyopathy patients attending a referral cardiovascular clinic, which suggests that a reduced stroke volume response, ventilation/perfusion mismatch, and abnormal peripheral oxygen utilisation are the possible mechanisms of exercise intolerance.
International Journal of CardiologyChronotropic incompetence in chronic heart failure
78 Citations1995Andrew L. Clark, Andrew J.S. Coats
Chronotropic incompetence is unlikely to be a major factor limiting exercise capacity in unselected patients with chronic heart failure and is likely to be the major factors limiting exercise in a much smaller proportion of patients.
The American Journal of CardiologySignificance of positive or negative thallium-201 scintigraphy in hypertrophic cardiomyopathy
67 Citations1989Thomas W. von Dohlen, L. Michael Prisant +1 more
Thallium perfusion abnormalities are common in patients withHC in the absence of epicardial coronary disease, and are strongly associated with potentially lethal arrhythmias, which appears to identify a subset of patients with HC at increased risk for sudden death, who therefore require closer follow-up.
The American Journal of CardiologyClinical significance and therapeutic implications of the left ventricular outflow tract pressure gradient in hypertrophic cardiomyopathy
65 Citations1986Barry J. Maron, Stephen E. Epstein
Evidence is provided that the radiolucent line in left anterior oblique cineangiograms, representing systolic anterior motion of the mitral valve (SAM), occurs almost simultaneously with the onset of the subaortic pressure gradient measured by catheter micromanometry, at which time the left ventricle still has a considerable quantity of blood remaining to be ejected.
European Heart JournalLeft ventricular outflow tract gradient decrease with non-surgical myocardial reduction improves exercise capacity in patients with hypertrophic obstructive cardiomyopathy
65 Citations2000W Ruzyllo
Significant left ventricular outflow tract gradient reduction with exercise capacity improvement was achieved in the majority of patients treated with non-surgical myocardial reduction, and this method is recommended as an alternative to surgery for symptomatic patients with hypertrophic obstructive cardiomyopathy.
The American Journal of CardiologyImprovement in exercise capacity and exercise blood pressure response after transcoronary alcohol ablation therapy of septal hypertrophy in hypertrophic cardiomyopathy
60 Citations1999Jae‐Joong Kim, Cheol Whan Lee +8 more
A time-course analysis of exercise capacity and exercise hemodynamics in 20 patients with symptomatic obstructive HC after TAA found that the pressure gradient of the left ventricular outflow tract immediately decreased.
Pacing and Clinical ElectrophysiologyChronotropic Response to Exercise in Patients with Atrial Fibrillation
58 Citations1990RICHARD CORBELLI, M. Masterson +1 more
Analysis of the heart rate response identifies disproportionately rapid and/or slow heart rates during exercise in patients with chronic atrial fibrillation requiring pacemaker therapy for bradycardia.
Pacing and Clinical ElectrophysiologyDecreased Heart Rate Variability in Patients with Congestive Heart Failure and Chronotropic Incompetence
52 Citations1996Fei Lü, Philip J. Keeling +5 more
The observation that heart rate variability is significantly decreased in patients with congestive heart failure who have chronotropic incompetence suggests that chronotropic incompetent may relate to an abnormal autonomic influence on the heart in these patients.
Pacing and Clinical ElectrophysiologyRate Responsive Dual Chamber Pacing
46 Citations1986Lukas Kappenberger, LOEK HERPERS
A new pacemaker, which simultaneously offers dual chamber pacing in DDD Mode and activity controlled rate response and activity‐sensing to differentiate true sinus tachycardia from ectopic atrial activity or atrial fibrillation, is reported about.
HeartAutonomic function in hypertrophic cardiomyopathy.
46 Citations1993David Gilligan, Wah Loong Chan +3 more
Patients with hypertrophic cardiomyopathy have a selective impairment of variability of heart rate with deep breathing and the Valsalva manoeuvre indicating decreased cardiac parasympathetic activity, and the data suggest that the afferent limb of these reflexes is impaired.
Current Cardiology ReportsPrevalence and management of chronotropic incompetence in heart failure
45 Citations2007Peter H. Brubaker, Dalane W. Kitzman
There is unambiguous evidence indicating that chronotropic impairment contributes significantly to the myriad of cardiovascular, neuromuscular, pulmonary, and neurohormonal maladaptations known to negatively impact the physical functional and quality of life of most heart failure patients.
The American Journal of CardiologyRelation between marked changes in left ventricular outflow tract gradient and disease progression in hypertrophic cardiomyopathy
44 Citations1984Elisabetta Ciró, Barry J. Maron +3 more
Substantial changes in the magnitude of basal subaortic obstruction may occur in a small proportion of patients with HC as part of the natural history of their disease, and such hemodynamic alterations are usually associated with clinical deterioration.
Pacing and Clinical ElectrophysiologyAssessment of Pacemaker Chronotropic Response: Implementation of the Wilkoff Mathematical Model
37 Citations2001Roger A. Freedman, Donald L. Hopper +3 more
The authors conclude that a simple treadmill walk (LITE) allowed for optimum programming of sensor parameters in most patients, but in a minority the chronotropic behavior was underresponsive.
Journal of Cardiac FailureVariables Associated With Contrast-Enhanced Cardiovascular Magnetic Resonance in Hypertrophic Cardiomyopathy: Clinical Implications
36 Citations2008Eduardo Payá, Francisco Marı́n +9 more
Increased maximal left ventricular wall thickness and nonsustained ventricular tachycardia are associated with late gadolinium enhancement, a common finding in HCM.
The American Journal of CardiologyRelation of Left Ventricular Chamber Stiffness at Rest to Exercise Capacity in Hypertrophic Cardiomyopathy
23 Citations2007Carlos Dumont, Lorenzo Monserrat +8 more
LV diastolic dysfunction at rest, as manifested by increased LV chamber stiffness, is a major determinant of maximal exercise capacity in patients with HC.
The American Journal of CardiologyPredictors of exercise benefit after operative relief of left ventricular outflow obstruction by the myotomy-myectomy procedure in hypertrophic cardiomyopathy
21 Citations1992Jean G. Diodati, William H. Schenke +3 more
Patients with obstructive hypertrophic cardiomyopathy, after failing medical therapy, are most likely to demonstrate improvement in exercise capacity if preoperative exercise testing demonstrates limited exercise capacity and if surgery achieves reduction in elevated resting LV outflow tract gradients and LV filling pressures.
The American Journal of CardiologyPrevalence of Systolic Impairment in an Unselected Regional Population With Hypertrophic Cardiomyopathy
16 Citations2006Georgios Efthimiadis, Georgios Giannakoulas +9 more
Revista Española de CardiologíaCardiorresonancia magnética con gadolinio y capacidad de esfuerzo en la miocardiopatía hipertrófica
10 Citations2008Antonio J. Romero-Puche, Francisco Marı́n +9 more
La presencia oferta de areas de realce tardio con gadolinio en la cardiorresonancia magnetica se asocia de forma independiente con una peor capacidad de esfuerzo en pacientes con miocardiopatia hipertrofica.
Revista Española de Cardiología (English Edition)Gadolinium-Enhanced Cardiovascular Magnetic Resonance and Exercise Capacity in Hypertrophic Cardiomyopathy
6 Citations2008Antonio J. Romero-Puche, Francisco Marı́n +9 more
The observation of areas of late gadolinium enhancement on cardiac magnetic resonance was independently associated with poor exercise capacity in patients with hypertrophic cardiomyopathy.
European Heart JournalNormal systolic function in hypertrophic cardiomyopathy: reality or myth?
4 Citations2008Georgios Efthimiadis, Soultana Meditskou +5 more
It was long believed that patients with hypertrophic cardiomyopathy (HCM) had normal or supranormal systolic function despite mutations in genes encoding for sarcomeric proteins, but this concept was, at least partly, based on the use of endocardial indices of syStolic function such as ejection fraction.
International Journal of CardiologyExercise testing in hypertrophic cardiomyopathy
4 Citations2007Tsung O. Cheng
International Journal of CardiologyExercise in hypertrophic cardiomyopathy is associated with sympatho-adrenal imbalance
3 Citations2006Ian Carl, Hui Xin Ong +3 more
The hypothesis that patients with HCM have an abnormal catecholamine response to exercise compared with controls is investigated and a statistically significant lower level of epinephrine at peak exercise is found.
