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June 19, 2026Journal of Applied PhysiologyOpen Access

Non-obstructive HCM shows a ~9 mmHg steeper exercise PAWP increase than obstructive disease.

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Why the study?

Does hemodynamic adaptation to exercise differ between obstructive and non-obstructive hypertrophic cardiomyopathy patients?

Population

25 patients with hypertrophic cardiomyopathy, subdivided into non-obstructive HCM and obstructive HCM.

Comparison

Supine left and right heart catheterization at… vs Non-obstructive HCM vs Obstructive HCM

Design

Cohort

Key result

During exercise, non-obstructive hypertrophic cardiomyopathy patients showed a steeper increase in pulmonary artery wedge pressure than those with obstructive disease (23±3 vs 14±3 mmHg; p<0.05).

Authors

CBClaudia BarattoSCSergio CaravitaGPGiovanni Battista Perego

Discussion

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Overview

May guide phenotype-specific dyspnea evaluation in HCM; leaves open targeted interventions pending larger studies.

Key Points

  • This research aims to evaluate how different types of hypertrophic cardiomyopathy (HCM) affect hemodynamics during exercise.
  • Twenty-five HCM patients underwent rest and exercise cardiac catheterization.
  • Patients were divided into non-obstructive HCM (no-HOCM) and obstructive HCM (HOCM) based on left ventricular outflow tract obstruction criteria.
  • Hemodynamic measurements included left ventricular end-diastolic pressure and pulmonary artery wedge pressure.
  • During exercise, pulmonary artery wedge pressure increased significantly more in no-HOCM compared to HOCM (23±3 vs 14±3 mmHg, p<0.05).
  • PAWP V waves also showed a greater increase in no-HOCM (+28±4 vs +14±3 mmHg, p<0.05).
  • In overt HOCM, LVOTO decreased by 22±8 mmHg during exercise (p<0.01).

Study Design

Type

Cross-Sectional (n=25)

Structured PICO

Does hemodynamic adaptation to exercise differ between obstructive and non-obstructive hypertrophic cardiomyopathy patients?

P
Population
25 patients with hypertrophic cardiomyopathy undergoing rest and exercise cardiac catheterization to assess hemodynamic adaptation.
E
Exposure
Supine left and right heart catheterization at rest and during exercise
C
Comparator
Non-obstructive HCM vs Obstructive HCM
O
Outcome
Hemodynamic adaptation to exercise (including LV end-diastolic pressure, mean pulmonary artery wedge pressure [PAWP], PAWP V waves, and LV outflow tract obstruction [LVOTO])surrogate

Main Result

Absolute Event Rate: 23% vs 14%

p-value: p=<0.05

Non-obstructive HCM patients display a steeper increase in left atrial pressure during exercise compared to obstructive HCM patients, suggesting more advanced left atrial myopathy, while LVOTO may paradoxically reduce during supine exercise in overt HOCM.

Cite This Study

Baratto et al. (2026) conducted a cross-sectional in Hypertrophic cardiomyopathy (n=25). Non-obstructive hypertrophic cardiomyopathy vs. Obstructive hypertrophic cardiomyopathy was evaluated on Increase in pulmonary artery wedge pressure (PAWP) during exercise (p=<0.05). During exercise, non-obstructive hypertrophic cardiomyopathy patients showed a steeper increase in pulmonary artery wedge pressure than those with obstructive disease (23±3 vs 14±3 mmHg; p<0.05).

synapsesocial.com/papers/6a35982fdd3be7785e70ecd6https://doi.org/10.1152/japplphysiol.00779.2025
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Role of stress Echo on the Prognosis of Hypertrophic Cardiomyopathy2015
  2. 2Cardiopulmonary exercise testing in hypertrophic cardiomyopathy: the role of reduced O2 pulse and chronotropic incompetence in myocardial adaptation2025 · 8 citations
  3. 3Hypercontractile phenotype in hypertrophic cardiomyopathy indicates unfavorable hemodynamics, coronary flow and prognosis2025 · 5 citations
  4. 4Exercise training in hypertrophic cardiomyopathy: a meta-analysis of randomised trials with trial sequential analysis2025 · 1 citations
  5. 5Evaluation of myocardial structure and function in hypertrophic obstructive cardiomyopathy via cardiovascular magnetic resonance: regional distribution and sex differences2025