Objective: To explore the relationship between pulse pressure and abnormal blood pressure response to exercise in patients with hypertrophic cardiomyopathy. Methods: 70 patients with hypertrophic cardiomyopathy admitted in our hospital from January 2007 to January 2012 underwent echocardiography for assessment of the cardiac dimensions followed by a symptom-limited exercise test using a standard Bruce protocol with a concurrent hemodynamic assessment. Measurement of blood pressure was proceeded after the patient supine rest and exercise. Results: In the patients with hypertrophic cardiomyopathy, post-exercise blood pressure response to abnormal resting pulse pressure was significantly higher than normal. Pulse pressure was significantly greater in patients with an abnormal blood pressure response to exercise than that without an abnormal blood pressure response to exercise (P=0.007). According to binary logistic regression analysis, pulse pressure at rest was a significant predictor of abnormal blood pressure response to exercise in patients with hypertrophic cardiomyopathy, excluding age, gender, left ventricular posterior wall thickness, septal thickness, left ventricular outflow tract obstruction(P=0.016). Conclusions: Pulse pressure at rest could be used as an effective auxiliary index to prevent the occurrence of sudden cardiac death in patients with hypertrophic cardiomyopathy.%目的:探讨肥厚型心肌病患者静息脉压和运动诱导的血压异常之间的关系.方法:根据Bruce方案,对70例2007年1月至2012年1月在我院治疗的肥厚型心肌病患者进行症状限制运动试验,监测患者的血液动力学指标,即分别在患者仰卧休息和运动结束后测量血压.结果:肥厚型心肌病患者中,运动后血压反应异常者与正常者相比,前者的静息脉压显著高于后者.表现出运动性非正常血压反应的肥厚型心肌病患者,静息脉压明显高于无运动性非正常血压反应患者(P=0.007).根据二分类Logistic回归分析,控制年龄、性别、左室后壁厚度、室间隔厚度、左室流出道梗阻等混杂因素后,静息脉压可以有效预测肥厚型心肌病患者的运动性非正常血压反应(P=0.016).结论:与传统的收缩压、舒张压以及平均动脉压相比,静息脉压可作为一个有效的辅助检测指标预防肥厚型心肌病患者心脏猝死的发生.
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