Skip to main content
Log in

Exercise stress echocardiography in hypertrophic cardiomyopathy

  • Review Article
  • Published:
Journal of Echocardiography Aims and scope Submit manuscript

Abstract

In this review, we make a comprehensive summary of exercise stress echocardiography in hypertrophic cardiomyopathy (HCM) and practical tips used in our hospital. The main objective of performing exercise stress echocardiography in patients with HCM is to evaluate left ventricular outflow tract obstruction, mitral regurgitation, left ventricular asynergy, and diastolic function during exercise. There are limitations to the explanations that can be provided for exertional symptoms when resting echocardiography is performed in patients with HCM. In contrast, exercise stress echocardiography causes the manifestation of findings that are latent at rest, which possibly provides the elucidation of symptom etiology. In this article, we focus on the usefulness of exercise stress echocardiography in HCM.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Elliott PM, Anastasakis A, Authors/Task Force members, et al. 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). Eur Heart J. 2014;2014(35):2733–79.

    Google Scholar 

  2. Otto CM. Textbook of clinical echocardiography. 5th ed. Philadelphia: Elsevier; 2013. p. 234.

    Google Scholar 

  3. Otto CM. Practice of clinical echocardiography. 4th ed. Philadelphia: Elsevier; 2012. p. 281.

    Google Scholar 

  4. Owens DS, Otto CM. Exercise testing for structural heart disease. In: Gillam L, Otto CM, editors. Advanced approaches in echocardiography. Philadelphia: Saunders; 2012.

    Google Scholar 

  5. Petkow Dimitrow P, Cotrim C, Cheng TO. Need for a standardized protocol for stress echocardiography in provoking subaortic and valvular gradient in various cardiac conditions. Cardiovasc Ultrasound. 2014;12:26.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Drinko JK, Nash PJ, Lever HM, et al. Safety of stress testing in patients with hypertrophic cardiomyopathy. Am J Cardiol. 2004;93:1443–4.

    Article  PubMed  Google Scholar 

  7. Maron MS, Olivotto I, Zenovich AG, et al. Hypertrophic cardiomyopathy is predominantly a disease of left ventricular outflow tract obstruction. Circulation. 2006;114:2232–9.

    Article  PubMed  Google Scholar 

  8. Shah JS, Esteban MT, Thaman R, et al. Prevalence of exercise-induced left ventricular outflow tract obstruction in symptomatic patients with non-obstructive hypertrophic cardiomyopathy. Heart. 2008;94:1288–94.

    Article  CAS  PubMed  Google Scholar 

  9. Nakatani S, Marwick TH, Lever HM, et al. Resting echocardiographic features of latent left ventricular outflow obstruction in hypertrophic cardiomyopathy. Am J Cardiol. 1996;78:662–7.

    Article  CAS  PubMed  Google Scholar 

  10. Lafitte S, Reant P, Touche C, et al. Paradoxical response to exercise in asymptomatic hypertrophic cardiomyopathy: a new description of outflow tract obstruction dynamics. J Am Coll Cardiol. 2013;62:842–50.

    Article  PubMed  Google Scholar 

  11. Peteiro J, Montserrat L, Castro-Beiras A. Labil subaortic obstruction during exercise stress echocardiography. Am J Cardiol. 1999;84:1119–23.

    Article  CAS  PubMed  Google Scholar 

  12. Ryan K, Murphy RT, DiPaola LM, et al. Mitral valve abnormalities in hypertrophic cardiomyopathy: echocardiographic features and surgical outcomes. Ann Thorac Surg. 2008;85:1527–35.

    Article  Google Scholar 

  13. Fighali S, Krajcer Z, Edelman S, et al. Progression of hypertrophic cardiomyopathy into a hypokinetic left ventricle: higher incidence in patients with midventricular obstruction. J Am Coll Cardiol. 1987;9:288–94.

    Article  CAS  PubMed  Google Scholar 

  14. Peteiro J, Bouzas-Mosquera A, Fernandez X, et al. Prognostic value of exercise echocardiography in patients with hypertrophic cardiomyopathy. J Am Soc Echocardiogr. 2012;25:182–9.

    Article  PubMed  Google Scholar 

  15. Reant P, Reynaud A, Pillois X, et al. Comparison of resting and exercise echocardiographic parameters as indicators of outcomes in hypertrophic cardiomyopathy. J Am Soc Echocardiogr. 2015;28:194–203.

    Article  PubMed  Google Scholar 

  16. Sherrrid MV, Mahenthiran J, Casteneda V, et al. Comparison of diastolic septal perforator flow velocities in hypertrophic cardiomyopathy versus hypertensive left ventricular hypertrophy. Am J Cardiol. 2006;97(1):106–12.

    Article  PubMed  Google Scholar 

  17. Mizukoshi K, Suzuki K, Yoneyama K, et al. Early diastolic function during exertion influences exercise intolerance in patients with hypertrophic cardiomyopathy. J Echocardiogr. 2013;11:9–17.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kengo Suzuki.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Suzuki, K., Akashi, Y.J. Exercise stress echocardiography in hypertrophic cardiomyopathy. J Echocardiogr 15, 110–117 (2017). https://doi.org/10.1007/s12574-017-0338-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12574-017-0338-4

Keywords

Navigation