Decreased exercise capacity and sleep-disordered breathing in patients with hypertrophic cardiomyopathy

Tomas Konecny; Jeffrey B. Geske; Ondrej Ludka; Marek Orban; Peter A. Brady; Muaz M. Abudiab; Felipe N. Albuquerque; Alexander Placek; Tomas Kara; Karine R. Sahakyan; Bernard J. Gersh; A. Jamil Tajik; Thomas G. Allison; Steve R. Ommen; Virend K. Somers

doi:10.1378/chest.14-1498

Decreased exercise capacity and sleep-disordered breathing in patients with hypertrophic cardiomyopathy

Tomas Konecny, Jeffrey B. Geske, Ondrej Ludka, Marek Orban, Peter A. Brady, Muaz M. Abudiab, Felipe N. Albuquerque, Alexander Placek, Tomas Kara, Karine R. Sahakyan, Bernard J. Gersh, A. Jamil Tajik, Thomas G. Allison, Steve R. Ommen, Virend K. Somers

Cardiovascular Medicine

Research output: Contribution to journal › Article › peer-review

10 Scopus citations

Abstract

BACKGROUND: Mechanisms of decreased exercise capacity in patients with hypertrophic cardiomyopathy (HCM) are not well understood. Sleep-disordered breathing (SDB) is a highly prevalent but treatable disorder in patients with HCM. The role of comorbid SDB in the attenuated exercise capacity in HCM has not been studied previously. METHODS: Overnight oximetry, cardiopulmonary exercise testing, and echocardiographic studies were performed in consecutive patients with HCM seen at the Mayo Clinic. SDB was considered present if the oxygen desaturation index (number of ≥ 4% desaturations/h) was ≥ 10. Peak oxygen consumption (Vo₂ peak) (the most reproducible and prognostic measure of cardiovascular fitness) was then correlated with the presence and severity of SDB. RESULTS: A total of 198 patients with HCM were studied (age, 53 ± 16 years; 122 men), of whom 32% met the criteria for the SDB diagnosis. Patients with SDB had decreased Vo₂peak compared with those without SDB (16 mL O₂/kg/min vs 21 mL O₂/kg/min, P<.001). SDB remained significantly associated with Vo₂peak after accounting for confounding clinical variables (P<.001) including age, sex, BMI, atrial fibrillation, and coronary artery disease. CONCLUSIONS: In patients with HCM, the presence of SDB is associated with decreased Vo₂peak. SDB may represent an important and potentially modifiable contributor to impaired exercise tolerance in this unique population.

Original language	English (US)
Pages (from-to)	1574-1581
Number of pages	8
Journal	Chest
Volume	147
Issue number	6
DOIs	https://doi.org/10.1378/chest.14-1498
State	Published - Jun 1 2015

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine
Critical Care and Intensive Care Medicine
Cardiology and Cardiovascular Medicine

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10.1378/chest.14-1498

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Konecny, T., Geske, J. B., Ludka, O., Orban, M., Brady, P. A., Abudiab, M. M., Albuquerque, F. N., Placek, A., Kara, T., Sahakyan, K. R., Gersh, B. J., Tajik, A. J., Allison, T. G., Ommen, S. R., & Somers, V. K. (2015). Decreased exercise capacity and sleep-disordered breathing in patients with hypertrophic cardiomyopathy. Chest, 147(6), 1574-1581. https://doi.org/10.1378/chest.14-1498

@article{c1f0280f70134fbe99b72a24c3e70fed,

title = "Decreased exercise capacity and sleep-disordered breathing in patients with hypertrophic cardiomyopathy",

abstract = "BACKGROUND: Mechanisms of decreased exercise capacity in patients with hypertrophic cardiomyopathy (HCM) are not well understood. Sleep-disordered breathing (SDB) is a highly prevalent but treatable disorder in patients with HCM. The role of comorbid SDB in the attenuated exercise capacity in HCM has not been studied previously. METHODS: Overnight oximetry, cardiopulmonary exercise testing, and echocardiographic studies were performed in consecutive patients with HCM seen at the Mayo Clinic. SDB was considered present if the oxygen desaturation index (number of ≥ 4% desaturations/h) was ≥ 10. Peak oxygen consumption (Vo2 peak) (the most reproducible and prognostic measure of cardiovascular fitness) was then correlated with the presence and severity of SDB. RESULTS: A total of 198 patients with HCM were studied (age, 53 ± 16 years; 122 men), of whom 32% met the criteria for the SDB diagnosis. Patients with SDB had decreased Vo2peak compared with those without SDB (16 mL O2/kg/min vs 21 mL O2/kg/min, P<.001). SDB remained significantly associated with Vo2peak after accounting for confounding clinical variables (P<.001) including age, sex, BMI, atrial fibrillation, and coronary artery disease. CONCLUSIONS: In patients with HCM, the presence of SDB is associated with decreased Vo2peak. SDB may represent an important and potentially modifiable contributor to impaired exercise tolerance in this unique population.",

author = "Tomas Konecny and Geske, {Jeffrey B.} and Ondrej Ludka and Marek Orban and Brady, {Peter A.} and Abudiab, {Muaz M.} and Albuquerque, {Felipe N.} and Alexander Placek and Tomas Kara and Sahakyan, {Karine R.} and Gersh, {Bernard J.} and Tajik, {A. Jamil} and Allison, {Thomas G.} and Ommen, {Steve R.} and Somers, {Virend K.}",

note = "Publisher Copyright: {\textcopyright} 2015 AMERICAN COLLEGE OF CHEST PHYSICIANS.",

year = "2015",

month = jun,

day = "1",

doi = "10.1378/chest.14-1498",

language = "English (US)",

volume = "147",

pages = "1574--1581",

journal = "Chest",

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TY - JOUR

T1 - Decreased exercise capacity and sleep-disordered breathing in patients with hypertrophic cardiomyopathy

AU - Konecny, Tomas

AU - Geske, Jeffrey B.

AU - Ludka, Ondrej

AU - Orban, Marek

AU - Brady, Peter A.

AU - Abudiab, Muaz M.

AU - Albuquerque, Felipe N.

AU - Placek, Alexander

AU - Kara, Tomas

AU - Sahakyan, Karine R.

AU - Gersh, Bernard J.

AU - Tajik, A. Jamil

AU - Allison, Thomas G.

AU - Ommen, Steve R.

AU - Somers, Virend K.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - BACKGROUND: Mechanisms of decreased exercise capacity in patients with hypertrophic cardiomyopathy (HCM) are not well understood. Sleep-disordered breathing (SDB) is a highly prevalent but treatable disorder in patients with HCM. The role of comorbid SDB in the attenuated exercise capacity in HCM has not been studied previously. METHODS: Overnight oximetry, cardiopulmonary exercise testing, and echocardiographic studies were performed in consecutive patients with HCM seen at the Mayo Clinic. SDB was considered present if the oxygen desaturation index (number of ≥ 4% desaturations/h) was ≥ 10. Peak oxygen consumption (Vo2 peak) (the most reproducible and prognostic measure of cardiovascular fitness) was then correlated with the presence and severity of SDB. RESULTS: A total of 198 patients with HCM were studied (age, 53 ± 16 years; 122 men), of whom 32% met the criteria for the SDB diagnosis. Patients with SDB had decreased Vo2peak compared with those without SDB (16 mL O2/kg/min vs 21 mL O2/kg/min, P<.001). SDB remained significantly associated with Vo2peak after accounting for confounding clinical variables (P<.001) including age, sex, BMI, atrial fibrillation, and coronary artery disease. CONCLUSIONS: In patients with HCM, the presence of SDB is associated with decreased Vo2peak. SDB may represent an important and potentially modifiable contributor to impaired exercise tolerance in this unique population.

AB - BACKGROUND: Mechanisms of decreased exercise capacity in patients with hypertrophic cardiomyopathy (HCM) are not well understood. Sleep-disordered breathing (SDB) is a highly prevalent but treatable disorder in patients with HCM. The role of comorbid SDB in the attenuated exercise capacity in HCM has not been studied previously. METHODS: Overnight oximetry, cardiopulmonary exercise testing, and echocardiographic studies were performed in consecutive patients with HCM seen at the Mayo Clinic. SDB was considered present if the oxygen desaturation index (number of ≥ 4% desaturations/h) was ≥ 10. Peak oxygen consumption (Vo2 peak) (the most reproducible and prognostic measure of cardiovascular fitness) was then correlated with the presence and severity of SDB. RESULTS: A total of 198 patients with HCM were studied (age, 53 ± 16 years; 122 men), of whom 32% met the criteria for the SDB diagnosis. Patients with SDB had decreased Vo2peak compared with those without SDB (16 mL O2/kg/min vs 21 mL O2/kg/min, P<.001). SDB remained significantly associated with Vo2peak after accounting for confounding clinical variables (P<.001) including age, sex, BMI, atrial fibrillation, and coronary artery disease. CONCLUSIONS: In patients with HCM, the presence of SDB is associated with decreased Vo2peak. SDB may represent an important and potentially modifiable contributor to impaired exercise tolerance in this unique population.

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U2 - 10.1378/chest.14-1498

DO - 10.1378/chest.14-1498

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C2 - 25633371

AN - SCOPUS:84930912981

SN - 0012-3692

VL - 147

SP - 1574

EP - 1581

JO - Chest

JF - Chest

IS - 6

ER -

Decreased exercise capacity and sleep-disordered breathing in patients with hypertrophic cardiomyopathy

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ASJC Scopus subject areas

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