Letter to the Editor
Clinical impact of cardiopulmonary exercise testing in hypertrophic cardiomyopathy
Impacto clínico del test de ejercicio cardiopulmonar en la miocardiopatía hipertrófica
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true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Clinical impact of cardiopulmonary exercise testing in hypertrophic cardiomyopathy" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "e15" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Alberto Dominguez-Rodriguez, Nestor Baez-Ferrer, Pedro Abreu-Gonzalez" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Alberto" "apellidos" => "Dominguez-Rodriguez" "email" => array:1 [ 0 => "adrvdg@hotmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Nestor" "apellidos" => "Baez-Ferrer" "referencia" => 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"titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Impacto clínico del test de ejercicio cardiopulmonar en la miocardiopatía hipertrófica" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Santos-Mateo et al. perform an update on hypertrophic cardiomyopathy (HCM) very interesting.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> However, we would like to point out an important aspect about of the dynamic evaluation of patients with hypertrophic cardiomyopathy and the cardiopulmonary exercise testing (CPET), a diagnostic tool which from our point of view, should not be forgotten.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">CPET is an established clinical tool used in the management of a variety of cardiac disorders.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> In patients with congestive heart failure, metabolic parameters such as peak myocardial oxygen consumption with maximal exercise identifies high-risk individuals requiring close monitoring as potential heart transplant candidates, and also with the potential of differentiating cardiac from pulmonary dyspnea.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In HCM, numerous cross-sectional studies have demonstrated that peak myocardial oxygen consumption correlates with a number of clinically relevant variables, including severity of diastolic function, quality of life, and (inversely) with outflow tract gradient.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> Also, intervention with myectomy or alcohol ablation to relieve outflow obstruction, a major determinant of heart failure symptoms in HCM, is associated with improved peak myocardial oxygen consumption.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> Furthermore, there are now substantial published reports relating CPET data to outcome in >3000 HCM patients reported from several major centers.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2,4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Recent European Society of Cardiology (ESC) treatment guidelines for HCM recommend that CPET be considered for all HCM patients undergoing invasive septal reduction therapy to assess severity of symptom limitation.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> However, a challenge remains in translating these broad ESC recommendations for CPET to guide management in different subgroups within the diverse HCM patient population.</p><p id="par0025" class="elsevierStylePara elsevierViewall">CPET maximum peak oxygen consumption can be useful in distinguishing HCM with relatively mild left ventricular hypertrophy from physiological hypertrophy (i.e., athlete's heart).<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> For individual athlete-patients within an ambiguous diagnostic “grey zone,” based on conventional imaging markers, a peak oxygen consumption >50<span class="elsevierStyleHsp" style=""></span>ml/kg/min (or >20% above the predicted maximum) is most consistent with athlete's heart and is nondiagnostic of HCM.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In conclusion, CPET can provide a quantitative assessment of functional limitation, with peak oxygen consumption a potential predictor and arbitrator for therapeutic decision-making in symptomatic patients with and without obstruction. Therefore, in this review,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> the omission of this technique could deprive at the medical community of potentially useful information and relevant in the current contemporary treatment era for this complex genetic disease.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hypertrophic cardiomyopathy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.J. Santos Mateo" 1 => "M. Sabater Molina" 2 => "J.R. Gimeno Blanes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2018" "volumen" => "150" "paginaInicial" => "434" "paginaFinal" => "442" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Role of exercise testing in hypertrophic cardiomyopathy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E.J. Rowin" 1 => "B.J. Maron" 2 => "I. Olivotto" 3 => "M.S. Maron" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jcmg.2017.07.016" "Revista" => array:6 [ "tituloSerie" => "JACC Cardiovasc Imaging" "fecha" => "2017" "volumen" => "10" "paginaInicial" => "1374" "paginaFinal" => "1386" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29122139" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cardiopulmonary exercise testing: what is its value?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Guazzi" 1 => "F. Bandera" 2 => "C. Ozemek" 3 => "D. Systrom" 4 => "R. Arena" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jacc.2017.08.012" "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2017" "volumen" => "70" "paginaInicial" => "1618" "paginaFinal" => "1636" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28935040" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cardiopulmonary exercise testing and prognosis in hypertrophic cardiomyopathy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.J. Coats" 1 => "K. Rantell" 2 => "A. Bartnik" 3 => "A. Patel" 4 => "B. Mist" 5 => "W.J. McKenna" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCHEARTFAILURE.114.002248" "Revista" => array:6 [ "tituloSerie" => "Circ Heart Fail" "fecha" => "2015" "volumen" => "8" "paginaInicial" => "1022" "paginaFinal" => "1031" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26374874" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.M. Elliott" 1 => "A. Anastasakis" 2 => "M.A. Borger" 3 => "M. Borggrefe" 4 => "F. Cecchi" 5 => "P. Charron" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/eurheartj/ehu284" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "2014" "volumen" => "35" "paginaInicial" => "2733" "paginaFinal" => "2779" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25173338" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015200000003/v1_201901290746/S2387020618305485/v1_201901290746/en/main.assets" "Apartado" => array:4 [ "identificador" => "43309" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015200000003/v1_201901290746/S2387020618305485/v1_201901290746/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020618305485?idApp=UINPBA00004N" ]
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