Pulmonary congestion during exercise stress echocardiography in hypertrophic cardiomyopathy

Abstract Background B-lines detected by lung ultrasound (LUS) indicate pulmonary congestion during exercise stress echo (ESE). Aim To assess ESE in hypertrophic cardiomyopathy (HCM). Methods We enrolled 110 HCM patients (age 52±16 years, 74 males) referred for (treadmill 39, semi-supine bicycle 71 patients) 10 quality-controlled centers from 8 countries (Belgium, Brazil, Bulgaria, Hungary, Italy, Portugal, Serbia, Spain). assessment included: left ventricular outflow tract gradient (LVOTG); mitral regurgitation (MR, score 0 to 3); E/e'; systolic arterial pressure (SPAP, tricuspid regurgitant jet velocity); end-diastolic volume (EDV); atrial (LAV). were assessed LUS with the 4-site simplified scan, each site scored (normal A-lines) (coalescing B-lines). The positivity criterion was a B-line ≥2 points. Results feasible all subjects, additional scanning and analysis time <1 minute stage (rest peak stress). present 13 at rest 33 (12 vs 30%, p<0.001). When compared without (Group 2, n=77), 1) showed higher values of change (Δ) LVOTG 1= 39±54 Group 2= 21±24 mm Hg, p=0.015) ΔMR grade 0.7±0.8 0.1±0.5, p<0.001), more frequent E/e' ≥15 1=61% 2=27%, p=0.007), lower EDV 86±35 102±33 ml, p=0.039) SPAP 60±21 39±12 p<0.001): see figure. At multivariable logistic regression analysis, presence predicted (odds ratio: 3.96, 95% CI 1.46–10.71) 4.95, 1.24–19.70). Conclusion are found about 1 3 ESE. Acute backward heart failure can recognize multiple mechanisms HCM, help capture this heterogeneity. FUNDunding Acknowledgement Type funding sources: None. Functional correlates