The Role of Cardiopulmonary Exercise Testing in Hypertrophic Cardiomyopathy

Lidija Mikic, Arsen Ristic, Natasa Markovic Nikolic, Milorad Tesic, Djordje G. Jakovljevic, Ross Arena, Thomas G. Allison, Dejana Popovic

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This review emphasizes the importance of cardiopulmonary exercise testing (CPET) in patients diagnosed with hypertrophic cardiomyopathy (HCM). In contrast to standard exercise testing and stress echoes, which are limited due to the ECG changes and wall motion abnormalities that characterize this condition, CPET allows for the assessment of the complex pathophysiology and severity of the disease, its mechanisms of functional limitation, and its risk stratification. It is useful tool to evaluate the risk for sudden cardiac death and select patients for cardiac resynchronization therapy (CRT), cardiac transplantation, or mechanical circulatory support, especially when symptomatology and functional status are uncertain. It may help in differentiating HCM from other forms of cardiac hypertrophy, such as athletes’ heart. Finally, it is used to guide and monitor therapy as well as for exercise prescription. It may be considered every 2 years in clinically stable patients or every year in patients with worsening symptoms. Although performed only in specialized centers, CPET combined with echocardiography (i.e., CPET imaging) and invasive CPET are more informative and provide a better assessment of cardiac functional status, left ventricular outflow tract obstruction, and diastolic dysfunction during exercise in patients with HCM.
Original languageEnglish
Article number1296
Number of pages12
JournalMedicina (Lithuania)
Issue number7
Publication statusPublished - 13 Jul 2023

Bibliographical note

This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (


  • cardiopulmonary exercise testing
  • hypertrophic cardiomyopathy


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