Exercise testing in hypertrophic cardiomyopathy

Abstract

Patients with hypertrophic cardiomyopathy (HCM) who are asymptomatic at rest often develop symptoms upon exercising. Therefore, exercise testing plays a very important role in both diagnosis and management of patients with HCM [ [1] Pelliccia F. Cianfrocca C. Pristipino C. et al. Cumulative exercise-induced left ventricular systolic and diastolic dysfunction in hypertrophic cardiomyopathy. Int J Cardiol. Dec 28 2006; ([Electronic publication ahead of print]) Google Scholar ]. However, many physicians are reluctant to perform exercise testing, because of the potential risks in accordance with the American College of Cardiology/American Heart Association guidelines published in 2002 [ [2] Gibbons R.J. Balady G.J. Bricker J.T. et al. ACC/AHA 2002 update for exercise testing: summary article. Circulation. 2002; 106: 1883-1892 Crossref PubMed Scopus (1018) Google Scholar ]. But studies at the Cleveland Clinic in 263 consecutive patients with HCM showed that exercise testing in patients with HCM is safe [ [3] Drinko J.K. Nash P.J. Lever H.M. Asher C.R. Safety of stress testing in patients with hypertrophic cardiomyopathy. Am J Cardiol. 2004; 93: 1443-1444 Abstract Full Text Full Text PDF PubMed Scopus (45) Google Scholar ]. As a matter of fact, although the American College of Cardiology/American Heart Association guidelines list HCM as a relative contraindication to exercise testing, they acknowledge that this recommendation “can be superseded if the benefits of exercise outweigh the risks” [ [2] Gibbons R.J. Balady G.J. Bricker J.T. et al. ACC/AHA 2002 update for exercise testing: summary article. Circulation. 2002; 106: 1883-1892 Crossref PubMed Scopus (1018) Google Scholar ]. There are several benefits of exercise testing in HCM.