Modeling Cardiac Hemodynamic Response During Exercise in Health and Hypertrophic Cardiomyopathy

摘要

Introduction: Hypertrophic cardiomyopathy (HCM) is associated with altered hemodynamics in the left ventricular outflow tract and tissue abnormalities. Exercise testing has become an integral and powerful tool for the noninvasive evaluation of HCM and, in some patients, it could define a treatment strategy. Objective: To model the hemodynamic alterations during exercise in healthy and HCM patients, obtained by noninvasive methods. Methods: Cardiac output (CO), heart rate (HR), arterial blood pressure (ABP) and Total Peripheral Resistance (TPR) were assessed during exercise. The evaluation included a curve-fitting approach (sigmoidal model) that allowed a quantitative comparison of CO profiles. Results: When compared to controls, patients with HCM showed reduced peak exercise cardiac output and demonstrated high peripheral resistance during exercise. Analysis of modeled it CO curves revealed a higher maximum rate of recovery in healthy individuals than in HCM patients. Conclusion: The application of the sigmoidal model showed to be efficient in the characterization of CO dynamics for the different studied groups.