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Abnormal Blood Pressure Response during Exercise in Hypertrophic Non-Obstructiv Cardiomyopathy Naoki Isobe 1 , Takuji Toyama 1 , Hideki Nagaoka 1 , Sachio Kubota 1 , Yoshiaki Kaneko 1 , Toshio Iizuka 1 , Susumu Imai 1 , Tadashi Suzuki 2 , Kazuhiko Murata 1 1The Second Department of Internal Medicine, Gunma University School of Medicine 2College of Medical Care and Technology, Gunma University Keyword: 非閉塞性肥大型心筋症 , 運動負荷 , 異常血圧反応 , hypertrophic non-obstructive cardiomyopathy , exercise , abnormal blood pressure response pp.71-75
Published Date 1996/1/15
DOI https://doi.org/10.11477/mf.1404901182
  • Abstract
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Abnormal blood pressure response during exercise has been documented in hypertrophic non-obstructive cardiomyopathy (HNCM). To elucidate the cause of abnormal blood pressure response, 50 patients with HNCM and 26 normal control subjects underwent radionuclide ventriculography at rest and during maxi-mal symptom limited supine bicycle exercise. We assessed blood pressure response, alterations in left ventricular function and systemic vascular resistance at rest and during exercise. Cardiac index at rest was measured using a Swan-Ganz catheter and, at peak exercise, was calculated by the ratio of the peak to the rest count. Abnormal blood pressure response was defined as hypotension or poor blood pressure response during exercise. All patients underwent echocardiogra-phy and 24-hour Holter monitoring. Abnormal blood pressure response was demonstrated in 32% of HNCM patients, which was higher than the 8% of normal control subjects (p<0.01). The HNCM patients with abnormal blood pressure response had a higher inci-dence of family history of hypertrophic cardiomyopa-thy or sudden cardiac death, and a higher incidence of history of syncope. The group also included more young patients than the group in which there was normal blood pressure response (p < 0.05). Ventricular tachycardia was not found during exercise and 24-hour Holter monitoring. In HNCM patients with abnormal blood pressure response, heart rate, ejection fraction, and cardiac index were similar to those in HNCM patients with normal blood pressure response and nor-mal control subjects. The resting systolic blood pres-sure and systemic vascular resistance were similar in three groups. But in HNCM patients with abnormal blood pressure response, systolic blood pressure and systemic vascular resistance at peak exercise were significantly lower than those in the other two groups (p <0.01). These results lead us to conclude that abnor-mal blood pressure response during exercise in HNCM patients relates not to impaired left ventricular func-tion, but to the excessive reduction of systemic vascular resistance. The syncope of HNCM patients may relate to the excessive reduction of systemic vascular resis-tance.


Copyright © 1996, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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