Exercise Echocardiography in Asymptomatic or Minimally Symptomatic HCM
Exercise Capacity, and Not Rest or Exercise LV Outflow Tract Gradients Predicts Long-Term Outcomes
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Results Patients were asymptomatic or minimally symptomatic on history, but 82% of patients achieved 100% of age-sex predicted METs had 1% event rate versus 12% in those achieving <85%. On stepwise multivariate survival analysis, percent of age-sex predicted METs (hazard ratio [HR]: 0.76; 95% confidence interval [CI]: 0.64 to 0.90), abnormal HRR (HR: 0.89; 95% CI: 0.82 to 0.97), and atrial fibrillation (HR: 2.73; 95% CI: 1.30 to 5.74) (overall, p < 0.001) independently predicted outcomes. Conclusions In asymptomatic or minimally symptomatic HCM patients, exercise stress testing provides excellent risk stratification, with a low event rate in patients achieving >100% of predicted METs.
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