Clinical application of myocardial work combined with cardiopulmonary exercise test in patients with hypertrophic cardiomyopathy
Objective To evaluate the cardiopulmonary function in patients with hypertrophic cardiomyopathy(HCM)by myocardial word combined with cardiopulmonary exercise test(CPET),and to investigate the correlation between myocardial work parameters,CPET parameters and left ventricular wall thickness.Methods Fifty-five patients with non-obstructive hy-pertrophic cardiomyopathy diagnosed in the First Hospital of Longyan from January 2022 to April 2023 were included in the HCM group,and 55 healthy volunteers from the same period were included in the control group.Cardiopulmonary exercise test was performed to obtain peak oxygen uptake(Peak VO2),anaerobic threshold(AT),oxygen pulse(VO2/HR),metabolic e-quivalents(METs),and the differences of these indicators between the two groups were compared.Two-dimensional ultrasound speckle tracking technique was used to obtain the overall longitudinal strain(GLS),peak time dispersion(PSD),the overall useful work(GCW),and the overall unwanted work(GWW),and the differences in the longitudinal strain of the left ventricular myocardium and the parameters of the left ventricular myocardial work before and after cardiorespiratory exercise test between the two groups were compared.Results Compared with the control group,the CPET parameters of Peak VO2,AT,VO2/HR and METs were significantly lower in the HCM group,and the differences were all statistically significant(P＜0.05).Changes in myocardial longitudinal strain and myocardial work parameters:compared with the pre-exercise period,the GLS was signifi-cantly reduced and the PSD was significantly prolonged after the exercise in the HCM group,and the differences were all statisti-cally significant(P＜0.05),while the GCW was not significantly increased;in the control group,the GCW was significantly increased after the exercise,however GLS and PSD did not change significantly.Compared with the control group,both pre-and post-exercise GLS and GCW were significantly reduced and PSD was significantly prolonged in the HCM group,and the differ-ences were statistically significant(P＜0.05).MWT was positively correlated with PSD(r=0.84,P＜0.001),negatively cor-related with GCW(r=-0.84,P＜0.001),and negatively correlated with Peak VO2(r=-0.45,P＜0.001).Conclusion Myocardial work combined with CPET can detect cardiopulmonary impairment in HCM patients at an early stage and provide a basis for clinical decision-making.
万方数据
维普
