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 withhypertrophic cardiomyopathy (HCMP) is one of the risk factors of sudden cardiacdeath.Aim. To study structural and functional parameters of the heart, vessels and24-hour blood pressure parameters in patients with HCMP and IRBP in physicalexertion.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 resultsof treadmill test the patients were selected into 2 groups: I group (n=10, of those 7women, mean age 51,4±13,9y.) with IRBP, II group (n=7, of those 6 women, meanage 56,0±9,3y.)with normal BP reaction in physical exertion.Results. Presence of IRBP in physical exertion was associated: with more significantdiastolic 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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