Rest and stress echocardiographic predictors of outcomes in patients with HCM
| Outcomes | Resting exam | Stress exam |
|---|---|---|
| Cardiovascular death | - LA size - LV diastolic and systolic dysfunction - Resting LVOT obstruction - Progression of MR - RV dysfunction | Exercise: - MR ≥ moderate - Increased E/e’ - WMAs - PHT Vasodilator: CFVR |
| SCD | - Degree of hypertrophy - “Mixed” apical HCM - LA size and function - LV diastolic and systolic dysfunction - Resting LVOT obstruction - Apical aneurysms | Exercise: PHT |
| HF with/without hospitalization | - “Mixed” apical HCM - LA size - LV diastolic and systolic dysfunction - Progression of MR - RV dysfunction | Exercise: - MR ≥ moderate - Increased E/e’ - WMAs - PHT Vasodilator: CFVR |
| Ventricular arrhythmias | - “Mixed” apical HCM - LA size and function - LV diastolic and systolic dysfunction - Resting LVOT obstruction - Apical aneurysms - RV dysfunction | Exercise: - MR ≥ moderate - Increased E/e’ - WMAs Vasodilator: CFVR |
| AF | LA size and function | Vasodilator: CFVR |
| Stroke | Resting LVOT obstruction | Exercise: - MR ≥ moderate - Increased E/e’ - WMAs - PHT Vasodilator: CFVR |
AF: atrial fibrillation; CFVR: coronary flow velocity reserve; E/e’: early LV inflow velocity to early tissue Doppler annulus velocity; LA: left atrial; LV: left ventricular; LVOT: LV outflow tract; MR: mitral regurgitation; PHT: pulmonary hypertension; RV: right ventricular; SCD: sudden cardiac death; WMAs: wall motion abnormalities