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Lookup NU author(s): Dr Nduka OkwoseORCiD, Dr Sarah Charman, Professor Djordje JakovljevicORCiD
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© 2024 Elsevier Inc.Aim: We sought the cardiopulmonary exercise testing (CPET) parameter that most accurately reflected therapeutic efficacy in patients with hypertrophic cardiomyopathy (HCM). Methods: Well-being questionnaire, N-terminal brain natriuretic peptide measurements, echocardiography, and CPET were performed in patients with symptomatic non-obstructive HCM during phase II, randomized, open-label multicentre study, before and after 16 weeks of traditional or sacubitril/valsartan treatment. Patients were followed 36 months after the initial CPET. Primary endpoints were changes in: 1) peak oxygen consumption (VO2); 2) VO2 at anaerobic threshold (AT); 3) oxygen pulse; 4) minute ventilation (VE)/carbon-dioxide (CO2) production slope; 5) VE/VCO2 at AT (VE/VCO2_AT); 6) VE/VCO2 nadir; 7) VE/VCO2 intercept; and 8) partial end-tidal pressure of carbon-dioxide (PETCO2) change during CPET. Results: Of 115 screened patients, 61 (52 ± 14 years, 43 % women) were included. Within subject therapy effects were detected only by the VE/VCO2 intercept and PETCO2 change, whereas the differences between medical regimens were detected by differences in VE/VCO2 nadir and VE/VCO2_AT changes after the treatment. The best predictors of the change in well-being were left ventricular outflow tract maximal gradient and VE/VCO2 intercept (B = 0.41,0.36; SE = 0.16,0.30; CI = 0.14–0.79, 0.15–1.14; p = 0.006,0.016, respectively). Adverse cardiac events were best predicted by the initial VE/VCO2 nadir. Conclusion: Ventilatory efficiency parameters outperform peak VO2 in gauging therapy effects in patients with HCM.
Author(s): Seman S, Tesic M, Babic M, Mikic L, Velicki L, Okwose NC, Charman SJ, Tafelmeier M, Olivotto I, Filipovic N, Ristic A, Arena R, Guazzi M, Jakovljevic D, Allison TG, Popovic D
Publication type: Article
Publication status: Published
Journal: Progress in Cardiovascular Diseases
Year: 2024
Pages: epub ahead of print
Online publication date: 16/10/2024
Acceptance date: 02/04/2024
ISSN (print): 0033-0620
ISSN (electronic): 1873-1740
Publisher: W.B. Saunders
URL: https://doi.org/10.1016/j.pcad.2024.10.005
DOI: 10.1016/j.pcad.2024.10.005
PubMed id: 39424165
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