Abstract

ROMERO T., Luis; GUTIERREZ S., Oswaldo; FERNANDEZ G., Ricardo  and  ESQUIVEL A., Lidieth. Evaluación del gradiente intraventricular durante ejercicio en pacientes con miocardiopatía hipertrófica no obstructiva. Rev. costarric. cardiol [online]. 2004, vol.6, n.1, pp.13-16. ISSN 1409-4142.

Introduction: The intraventricular gradient in patients with hypertrophic cardiomyopathy, is usually assessed under resting conditions. In the present study we evaluated it during exercise, blood pressure response and functional capacity in this population. Materials and methods: Patients were eligible if they had an echocardiographic diagnosis of hypertrophic cardiomyopathy and no significant intraventricular gradient (25 mmHg). Every patient underwent a maximal physical stress test (Bruce protocol). The intraventricular gradient was again measured in the immediate post-exercise period using Doppler ultrasound. Results: We studied 12 patients (6 male and 6 females) with a mean age of 45.4 (31-60) all of them with no significant intraventricular gradient (mean 7 mmHg) and mean rest blood pressure 117 .91/72.5 mmHg. Their mean time of exercise was 8.3 minutes, their mean intraventricular gradient at maximal exercise was 14.41 mmHg and their mean maximal exercise blood pressure was 140.91/76.66 mmHg. Three patients had not a normal rise in blood pressure with exercise. Conclusion: Patients with hypertrophic cardiomyopathy and a non significant intraventricular gradient under resting conditions, did not show a significant increase of this, with exercise. However, some patients did not show an elevation of their normal systolic blood pressure which makes them part of a high risk population. In general, their functional capacity was low.

Keywords : Intraventricular gradient; exercise; hypertrophic cardiomyopathy.