TY - JOUR T1 - Cardiopulmonary exercise test and sudden cardiac death risk in hypertrophic cardiomyopathy JF - Heart JO - Heart SP - 602 LP - 609 DO - 10.1136/heartjnl-2015-308453 VL - 102 IS - 8 AU - Damiano Magrì AU - Giuseppe Limongelli AU - Federica Re AU - Piergiuseppe Agostoni AU - Elisabetta Zachara AU - Michele Correale AU - Vittoria Mastromarino AU - Caterina Santolamazza AU - Matteo Casenghi AU - Giuseppe Pacileo AU - Fabio Valente AU - Beatrice Musumeci AU - Antonello Maruotti AU - Massimo Volpe AU - Camillo Autore Y1 - 2016/04/15 UR - http://heart.bmj.com/content/102/8/602.abstract N2 - Background In hypertrophic cardiomyopathy (HCM), most of the factors associated with the risk of sudden cardiac death (SCD) are also involved in the pathophysiology of exercise limitation. The present multicentre study investigated possible ability of cardiopulmonary exercise test in improving contemporary strategies for SCD risk stratification.Methods A total of 623 consecutive outpatients with HCM, from five tertiary Italian HCM centres, were recruited and prospectively followed, between September 2007 and April 2015. The study composite end point was SCD, aborted SCD and appropriate implantable cardioverter defibrillator (ICD) interventions.Results During a median follow-up of 3.7 years (25th–75th centile: 2.2–5.1 years), 25 patients reached the end point at 5 years (3 SCD, 4 aborted SCD, 18 appropriate ICD interventions). At multivariate analysis, ventilation versus carbon dioxide relation during exercise (VE/VCO2 slope) remains independently associated to the study end point either when challenged with the 2011 American College of Cardiology Foundation/American Heart Association guidelines-derived score (C index 0.748) or with the 2014 European Society of Cardiology guidelines-derived score (C index 0.750). A VE/VCO2 slope cut-off value of 31 showed the best accuracy in predicting the SCD end point within the entire HCM study cohort (sensitivity 64%, specificity 72%, area under the curve 0.72).Conclusions Our data suggest that the VE/VCO2 slope might improve SCD risk stratification, particularly in those HCM categories classified at low-intermediate SCD risk according to contemporary guidelines. There is a need for further larger studies, possibly on independent cohorts, to confirm our preliminary findings. ER -