CARDIOVASCULAR HEMODYNAMICS AND SPECIFICS OF 24-HOUR BP PROFILE IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY AND INADEQUATE BP REACTION ON PHYSICAL EXERTION

Inadequate reaction of blood pressure (IRBP) in physical exertion in patients with
hypertrophic cardiomyopathy (HCMP) is one of the risk factors of sudden cardiac
death.
Aim. To study structural and functional parameters of the heart, vessels and
24-hour blood pressure parameters in patients with HCMP and IRBP in physical
exertion.
Material and methods. 17 patients with HCMP (13 women, meanage54,0±11,4y.)
underwent echocardiography (EchoCG), ambulatory blood pressure monitoring
(ABPM) with assessment of vessels rigidity, exercise test on treadmill. By the results
of treadmill test the patients were selected into 2 groups: I group (n=10, of those 7
women, mean age 51,4±13,9y.) with IRBP, II group (n=7, of those 6 women, mean
age 56,0±9,3y.)with normal BP reaction in physical exertion.
Results. Presence of IRBP in physical exertion was associated: with more significant
diastolic dysfunction of the left ventricle (LV): the correlation is found with the peak delayed diastolic filling on mitral valve (peak A mv)(r=-0,76, p=0,002), relation of the velocities of early and delayed diastolic filling on the mitral valve (E/A mv) (r=0,53, p=0,03); decreased volume of LV: correlation with end-diastolic volume (EDV); end systolic volume (ESV) (r=-0,55, p=0,03); increased stiffness of arterial wall: correlation with the velocity of pulse wave (PWVao) (r=0,7, p=0,005), ambulatory index of vessel rigidity (MSI) (r=0,49, p=0,05), augmentation index (Axi) (r=-0,51, p=0,04).
In discriminate analysis the EDV, E/A and AASI were the most significant predictors of IRBP. The functions were invented that make, by the highest value, an separation of a patients into one of 2 groups: I group (n=10, of those 7 women, mean age 51,4±13,9y.) with IRBP, II group (n=7, of those 6 women, mean age 56,0±9,3y.) with normal reaction of BP to physical exertion.

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