Exercise Response in Hypertrophic Cardiomyopathy

Soullier, Camille; Obert, Philippe; Doucende, Grégory; Nottin, Stéphane; Cade, Stéphane; Perez-Martin, Antonia; P, Messner-Pellenc; Schuster, Iris

doi:10.1161/circimaging.111.968859

Cited by 61 publications

(37 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Contraction of the LV is achieved by myocyte shortening of the oblique and circumferential fibres and, following a complex rearrangement of the microstructure of the LV (LeGrice et al 1995), results in a twisting motion around the LV long axis and circumferential shortening, respectively (Sengupta et al 2008). Previous studies have shown that LV twist plays an essential role in the efficient ejection of blood (Soullier et al 2012). Additionally, LV twist appears to be related to the regional O 2 distribution across the LV muscle (Beyar & Sideman, 1986) and has been implicated in stress sensing (Vendelin et al 2002).…”

Section: Introductionmentioning

confidence: 99%

Interaction between left ventricular twist mechanics and arterial haemodynamics during localised, non‐metabolic hyperaemia with and without blood flow restriction

Mil

Pearson

Drane

et al. 2016

Experimental Physiology

View full text Add to dashboard Cite

What is the central question of this study? Left ventricular (LV) twist is reduced when afterload is increased, but the meaning of this specific heart muscle response and its impact on cardiac output are not well understood. What is the main finding and its importance? This study shows that LV twist responds even when arterial haemodynamics are altered only locally, and without apparent change in metabolic (i.e. heat-induced) demand. The concurrent decline in cardiac output and LV twist during partial arterial occlusion despite the increased peripheral demand caused by heat stress suggests that LV twist may be involved in the protective sensing of heart muscle stress that can override the provision of the required cardiac output. Whether left ventricular (LV) twist and untwisting rate (LV twist mechanics) respond to localised, peripheral, non-metabolic changes in arterial haemodynamics within an individual's normal afterload range is presently unknown. Furthermore, previous studies indicate that LV twist mechanics may override the provision of cardiac output, but this hypothesis has not been examined purposefully. Therefore, we acutely altered local peripheral arterial haemodynamics in 11 healthy humans (women/men n = 3/8; age 26 ± 5 years) by bilateral arm heating (BAH). Ultrasonography was used to examine arterial haemodynamics, LV twist mechanics and the twist-to-shortening ratio (TSR). To determine the arterial function-dependent contribution of LV twist mechanics to cardiac output, partial blood flow restriction to the arms was applied during BAH (BAHBFR ). Bilateral arm heating increased arm skin temperatures [change (Δ) +6.4 ± 0.9°C, P < 0.0001] but not core temperature (Δ -0.0 ± 0.1°C, P > 0.05), concomitant to increases in brachial artery blood flow (Δ 212 ± 77 ml, P < 0.0001), cardiac output (Δ 495 ± 487 l min(-1) , P < 0.05), LV twist (Δ 3.0 ± 3.5 deg, P < 0.05) and TSR (Δ 3.3 ± 1.3, P < 0.05) but maintained carotid artery blood flow (Δ 18 ± 147 ml, P > 0.05). Subsequently, BAHBFR reduced all parameters to preheating levels, except for TSR and heart rate, which remained at BAH levels. In conclusion, LV twist mechanics responded to local peripheral arterial haemodynamics within the normal afterload range, in part independent of TSR and heart rate. The findings suggest that LV twist mechanics may be more closely associated with intrinsic sensing of excessive pressure stress rather than being associated with the delivery of adequate cardiac output.

show abstract

Section: Introductionmentioning

confidence: 99%

Interaction between left ventricular twist mechanics and arterial haemodynamics during localised, non‐metabolic hyperaemia with and without blood flow restriction

Mil

Pearson

Drane

et al. 2016

Experimental Physiology

View full text Add to dashboard Cite

show abstract

“…скручивание ЛЖ не отличалось от контроля во время нагрузочной пробы и было до-стоверно выше по сравнению с систолической СН [39]. В работе других авторов у лиц с диастолической СН и со-храненной ФВ ЛЖ получены меньшие показатели при-роста скручивания и раскручивания по сравнению с конт-ролем при физической нагрузке [17,40]. Представленные факты роли скручивания и раскручивания при диасто-лической дисфункции подчас сложно объяснить, поэтому необходимы дальнейшие исследования для разреше-ния этих противоречий [12].…”

Section: клиническое значение скручивания и рас-кручиванияunclassified

“…Несмотря на сохраненную амплитуду скручивания и не-значительное снижение скорости диастолического рас-кручивания, у пациентов с гипертрофической кардио-миопатией наблюдается существенно более низкий при-Ротация, скручивание и раскручивание левого желудочка рост скручивания, скорости скручивания и раскручи-вания во время физической нагрузки по сравнению с контролем. Более того, прирост скручивания может во-обще отсутствовать, указывая на полное истощение ком-пенсаторных резервов, что может объяснять появление ДСН в этой группе [17,40]. Динамическая обструкция выносящего тракта ЛЖ у лиц с гипертрофической кар-диомиопатией также сопровождается задержкой рас-кручивания.…”

Section: клиническое значение скручивания и рас-кручиванияunclassified

Left Ventricular Rotation, Twist and Untwist: Physiological Role and Clinical Relevance

Pavlyukova

Kuzhel

Matyushin

et al. 2015

Racionalʹnaâ farmakoterapiâ v kardiologii

View full text Add to dashboard Cite

ВведениеЗа прошедшие три столетия механическая работа сердца оставалась одним из наиболее интригующих аспектов для физиологов и клиницистов, изучающих этот орган. Еще в 1669 г. было описано уникальное движение скручивания левого желудочка (ЛЖ) [1], физиологи-ческое значение которого становится понятным только сегодня. В попытке исследовать эту важную особенность сердечного сокращения были предложены многочис-ленные методы, такие, как имплантируемые датчики, киноангиография и магнитный резонанс. Однако внед-рение ультразвуковой недопплеровской методики «от-слеживание пятна» (Speckle Tracking Imaging) открыло новые возможности в изучении этой особенности сер-дечного сокращения и сделало его исследование до-ступным в общей клинической практике, в том числе у постели больного. Теория желудочковой мышечной ленты представляет собой новую концепцию, обеспечивающую твердое основание для согласования некоторых важных понятий в сердечно-сосудистой медицине. Спиральная ориентация волокон обеспечивает вращение левого желудочка, которое, вместе с радиальным утолщением и продоль-ным сокращением, предполагается как необходимый компонент эффективной насосной функции левого желудочка. Вращение левого желудочка может быть неин-вазивно оценено в клинической практике с помощью эхокардиографии, что предоставляет новые возможности для оценки различных аспектов механической функ-ции левого желудочка. The helical ventricular myocardial band of Torrent-Guasp is a new concept, which provides strong grounds for reconciliation of some important aspects in cardiovascular medicine. Oblique fiber orientation provides left ventricular rotation, which in addition to radial thickening and longitudinal shortening, is predicted as an essential component of the effective left ventricular pumping. Left ventricular rotation can be measured in clinical practice noninvasively using echocardiography and this provides new opportunities for the assessment of different aspects of left ventricular mechanical function. История изучения скручивания сердца

show abstract

“…They had reduced and delayed UTR with reduced systolic-diastolic coupling efficiency by twist-untwist mechanics. 20 …”

Section: Comprehensive Use Of Cardiopulmonary Exercise Testing Identimentioning

confidence: 99%

Circulation: Heart Failure Editors’ Picks

Wilkins¹

2014

Circ: Heart Failure

View full text Add to dashboard Cite

Summary: Lifelong exercise training maintains a youthful compliance of the left ventricle (LV), whereas a year of exercise training started later in life fails to reverse LV stiffening, possibly because of accumulation of irreversible advanced glycation end products. Alagebrium is a novel drug that breaks advanced glycation end product crosslinks and improves LV stiffness in aged animals. In this study, the authors prescribed alagebrium (200 mg daily) or placebo combined with aerobic exercise training or contact control in healthy, sedentary older individuals for 1 year. The authors evaluated overall cardiac function by the use of several modalities, including invasive pressure-volume measurements, exercise testing, and cardiac MRI before and after the training. To the authors' knowledge, this is the first study to evaluate the effects of alagebrium and exercise training in healthy aged humans. After intervention, exercise training significantly increased exercise capacity, LV mass, and LV end-diastolic volume. Conversely, alagebrium had little effect on exercise capacity or LV geometry. However, alagebrium showed a modest improvement in LV stiffness compared with placebo. This favorable effect of alagebrium on LV stiffness was most prominent in individuals with combined alagebrium and exercise training.Conclusions: Alagebrium had no effect on hemodynamics, LV geometry, or exercise capacity in healthy, previously sedentary seniors. However, it did show a modestly favorable effect on age-associated LV stiffening. 1 Prognostic Value of Exercise Testing During Heart Transplant Evaluation in ChildrenSummary: Maximum oxygen consumption (peak VO2) and efficiency of ventilation (VE) during exercise (VE/VCO2 slope) are known to stratify adults in heart failure for 1-year survival. On the basis of adult data, a recent American Heart Association scientific statement suggested that peak VO2<50% predicted for age and sex should be considered substantial impairment in exercise performance in children with heart disease and therefore a class I indication for heart transplant listing. This single-center study examined the association of peak VO2<50% predicted with risk of death or deterioration in 50 children evaluated for heart transplant during 2002 to 2011 (32 biventricular circulation, 18 palliated single ventricle). Overall, 24 children reached the composite end point (death, urgent transplant, or initiation of mechanical support). Although children with peak VO2<50% predicted and those with peak VO2≥50% predicted were equally likely to be listed, children with peak VO2<50% predicted were at 4.7-fold risk of death or deterioration on follow-up compared with those with peak VO2≥50% predicted among those with a biventricular circulation. VE/ VCO2 slope ≥34 during exercise testing was also associated with poor outcome in children with biventricular circulation. Exercise testing was unable to risk-stratify children with a palliated single ventricle. Conclusions:Exercise testing during HT evaluation in children with biventricu...

show abstract

Exercise Response in Hypertrophic Cardiomyopathy

Abstract: Background-Abnormal left ventricular (LV) deformational mechanics have been demonstrated in patients withhypertrophic cardiomyopathy (HCM) at rest, but there is a lack of information on their adaptation to exercise.

Cited by 61 publications

References 38 publications

Interaction between left ventricular twist mechanics and arterial haemodynamics during localised, non‐metabolic hyperaemia with and without blood flow restriction

Interaction between left ventricular twist mechanics and arterial haemodynamics during localised, non‐metabolic hyperaemia with and without blood flow restriction

Left Ventricular Rotation, Twist and Untwist: Physiological Role and Clinical Relevance

Circulation: Heart Failure Editors’ Picks

Contact Info

Product

Resources

About