Tomas Konecny1, Jeffrey B Geske2, Ondrej Ludka3, Marek Orban4, Peter A Brady2, Muaz M Abudiab2, Felipe N Albuquerque5, Alexander Placek6, Tomas Kara7, Karine R Sahakyan2, Bernard J Gersh2, A Jamil Tajik2, Thomas G Allison2, Steve R Ommen2, Virend K Somers8. 1. Mayo Clinic, Rochester, MN; St. Anne's University Hospital, International Clinical Research Center (ICRC), Brno, Czech Republic. 2. Mayo Clinic, Rochester, MN. 3. St. Anne's University Hospital, International Clinical Research Center (ICRC), Brno, Czech Republic; Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic. 4. St. Anne's University Hospital, International Clinical Research Center (ICRC), Brno, Czech Republic; Center for Cardiovascular and Transplant Surgery (CKTCH), Brno, Czech Republic. 5. Mayo Clinic, Rochester, MN; Yale University, New Haven, CT. 6. Mayo Clinic, Rochester, MN; Georgetown University Medical Center, Washington, DC. 7. Mayo Clinic, Rochester, MN; Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic; Mayo Clinic, Rochester, MN; Department of Cardiology, University Hospital Olomouc, Olomouc, Czech Republic. 8. Mayo Clinic, Rochester, MN; St. Anne's University Hospital, International Clinical Research Center (ICRC), Brno, Czech Republic. Electronic address: somers.virend@mayo.edu.
Abstract
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 (VO2 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 VO2 peak compared with those without SDB (16 mL O2/kg/min vs 21 mL O2/kg/min, P < .001). SDB remained significantly associated with VO2 peak after 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 VO2 peak. SDB may represent an important and potentially modifiable contributor to impaired exercise tolerance in this unique population.
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 (VO2 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 VO2 peak compared with those without SDB (16 mL O2/kg/min vs 21 mL O2/kg/min, P < .001). SDB remained significantly associated with VO2 peak after 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 VO2 peak. SDB may represent an important and potentially modifiable contributor to impaired exercise tolerance in this unique population.
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Authors: John B Dixon; Linda M Schachter; Paul E O'Brien; Kay Jones; Mariee Grima; Gavin Lambert; Wendy Brown; Michael Bailey; Matthew T Naughton Journal: JAMA Date: 2012-09-19 Impact factor: 56.272
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Authors: Iacopo Olivotto; Barry J Maron; Benedetta Tomberli; Evan Appelbaum; Carol Salton; Tammy S Haas; C Michael Gibson; Stefano Nistri; Eleonora Servettini; Raymond H Chan; James E Udelson; John R Lesser; Franco Cecchi; Warren J Manning; Martin S Maron Journal: J Am Coll Cardiol Date: 2013-04-30 Impact factor: 24.094
Authors: Lena L Law; Kate E Sprecher; Ryan J Dougherty; Dorothy F Edwards; Rebecca L Koscik; Catherine L Gallagher; Cynthia M Carlsson; Henrik Zetterberg; Kaj Blennow; Sanjay Asthana; Mark A Sager; Bruce P Hermann; Sterling C Johnson; Dane B Cook; Barbara B Bendlin; Ozioma C Okonkwo Journal: J Alzheimers Dis Date: 2019 Impact factor: 4.472
Authors: Daokun Sun; Hartzell V Schaff; Virend K Somers; Rick A Nishimura; Jeffrey B Geske; Joseph A Dearani; Steve R Ommen Journal: CJC Open Date: 2022-07-11