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Venous dysfunction in obstructive hypertrophic cardiomyopathies: Results from the “HCM-Vein” pilot study

BACKGROUND: Hypertrophic cardiomyopathies (HCM) can be complicated by left ventricular outflow-tract obstruction (LVOTO) responsible for disabling exercise symptoms, a phenomenon influenced by hemodynamic factors including venous return. METHODS: We aimed to evaluate venous dysfunction in obstructiv...

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Autores principales: Réant, Patricia, Bonnet, Guillaume, Massie, Charles, Dezellus, Alexandre, Reynaud, Amélie, Michaud, Matthieu, James, Chloé, Constans, Joël, Lafitte, Stéphane
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10040706/
https://www.ncbi.nlm.nih.gov/pubmed/36993942
http://dx.doi.org/10.1016/j.ijcha.2023.101198
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author Réant, Patricia
Bonnet, Guillaume
Massie, Charles
Dezellus, Alexandre
Reynaud, Amélie
Michaud, Matthieu
James, Chloé
Constans, Joël
Lafitte, Stéphane
author_facet Réant, Patricia
Bonnet, Guillaume
Massie, Charles
Dezellus, Alexandre
Reynaud, Amélie
Michaud, Matthieu
James, Chloé
Constans, Joël
Lafitte, Stéphane
author_sort Réant, Patricia
collection PubMed
description BACKGROUND: Hypertrophic cardiomyopathies (HCM) can be complicated by left ventricular outflow-tract obstruction (LVOTO) responsible for disabling exercise symptoms, a phenomenon influenced by hemodynamic factors including venous return. METHODS: We aimed to evaluate venous dysfunction in obstructive HCM patients compared to healthy controls, and to investigate the relationship between venous dysfunction parameters and LVOTO in HCM. This is a clinical, monocentric, prospective, pilot study, in a tertiary care center. We investigated venous function using venous air plethysmography, and endothelial function. RESULTS: Among the 30 symptomatic obstructive HCM patients, 30% (n = 9) presented abnormal venous residual volume fraction (RVFv) which translates in elevated ambulatory venous pressure vs. 0% in the 10 healthy controls (p < 0.05). Comparing obstructive HCM patients with abnormal RVFv (n = 9) to other obstructive HCM patients with normal RVFv (n = 21), there were no significant differences in terms of age, sex (67% male), and classical echocardiographic parameters both at rest and during exercise, except for left ventricular end-diastolic volume index which was significantly lower in the group with abnormal RVFv compared to the other HCM patients (40.1 ± 9.0 ml/m(2)vs. 50.2 ± 10.6 ml/m(2), p = 0.01). Fifty six percent of obstructive HCM patients with abnormal RVFv had an absolute increase in Willebrand factor (vs. 26% of other obstructive HCM patients, p < 0.05). CONCLUSIONS: In this pilot monocentric study, venous insufficiency was observed in about 30% of symptomatic obstructive HCM patients. Patients with venous insufficiency had more frequently a smaller LV cavity volume. Due to the small sample size, this study is only hypothesis-generating, and further investigations are needed.
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spelling pubmed-100407062023-03-28 Venous dysfunction in obstructive hypertrophic cardiomyopathies: Results from the “HCM-Vein” pilot study Réant, Patricia Bonnet, Guillaume Massie, Charles Dezellus, Alexandre Reynaud, Amélie Michaud, Matthieu James, Chloé Constans, Joël Lafitte, Stéphane Int J Cardiol Heart Vasc Original Paper BACKGROUND: Hypertrophic cardiomyopathies (HCM) can be complicated by left ventricular outflow-tract obstruction (LVOTO) responsible for disabling exercise symptoms, a phenomenon influenced by hemodynamic factors including venous return. METHODS: We aimed to evaluate venous dysfunction in obstructive HCM patients compared to healthy controls, and to investigate the relationship between venous dysfunction parameters and LVOTO in HCM. This is a clinical, monocentric, prospective, pilot study, in a tertiary care center. We investigated venous function using venous air plethysmography, and endothelial function. RESULTS: Among the 30 symptomatic obstructive HCM patients, 30% (n = 9) presented abnormal venous residual volume fraction (RVFv) which translates in elevated ambulatory venous pressure vs. 0% in the 10 healthy controls (p < 0.05). Comparing obstructive HCM patients with abnormal RVFv (n = 9) to other obstructive HCM patients with normal RVFv (n = 21), there were no significant differences in terms of age, sex (67% male), and classical echocardiographic parameters both at rest and during exercise, except for left ventricular end-diastolic volume index which was significantly lower in the group with abnormal RVFv compared to the other HCM patients (40.1 ± 9.0 ml/m(2)vs. 50.2 ± 10.6 ml/m(2), p = 0.01). Fifty six percent of obstructive HCM patients with abnormal RVFv had an absolute increase in Willebrand factor (vs. 26% of other obstructive HCM patients, p < 0.05). CONCLUSIONS: In this pilot monocentric study, venous insufficiency was observed in about 30% of symptomatic obstructive HCM patients. Patients with venous insufficiency had more frequently a smaller LV cavity volume. Due to the small sample size, this study is only hypothesis-generating, and further investigations are needed. Elsevier 2023-03-21 /pmc/articles/PMC10040706/ /pubmed/36993942 http://dx.doi.org/10.1016/j.ijcha.2023.101198 Text en © 2023 The Authors. Published by Elsevier B.V. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Paper
Réant, Patricia
Bonnet, Guillaume
Massie, Charles
Dezellus, Alexandre
Reynaud, Amélie
Michaud, Matthieu
James, Chloé
Constans, Joël
Lafitte, Stéphane
Venous dysfunction in obstructive hypertrophic cardiomyopathies: Results from the “HCM-Vein” pilot study
title Venous dysfunction in obstructive hypertrophic cardiomyopathies: Results from the “HCM-Vein” pilot study
title_full Venous dysfunction in obstructive hypertrophic cardiomyopathies: Results from the “HCM-Vein” pilot study
title_fullStr Venous dysfunction in obstructive hypertrophic cardiomyopathies: Results from the “HCM-Vein” pilot study
title_full_unstemmed Venous dysfunction in obstructive hypertrophic cardiomyopathies: Results from the “HCM-Vein” pilot study
title_short Venous dysfunction in obstructive hypertrophic cardiomyopathies: Results from the “HCM-Vein” pilot study
title_sort venous dysfunction in obstructive hypertrophic cardiomyopathies: results from the “hcm-vein” pilot study
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10040706/
https://www.ncbi.nlm.nih.gov/pubmed/36993942
http://dx.doi.org/10.1016/j.ijcha.2023.101198
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