Heart failure & cardiomyopathiesCohort study
Long-term prognostic value of cardiopulmonary exercise testing in patients with hypertrophic cardiomyopathy
- longitudinal study
Authors' conclusion
In this long follow-up study, CPET is a powerful prognostic tool in HCM. A reduced peak VO2 identifies those at higher risk, highlighting the potential for CPET to improve risk stratification, even among patients classified as NYHA Class I.
Study context
- Population
- Hypertrophic cardiomyopathy (HCM) patients who underwent symptom-limited cardiopulmonary exercise testing (CPET)HCM patients, New York Heart Association (NYHA) Class I 98, Class II 48, Class III 8 · NYHA Class I 98 · NYHA Class II 48 · NYHA Class III 8
- Participants
- 154 patients
- Exposure
- PVO2% < 60 vs NYHA Class >I
Main finding
As reported in the abstract
MACE:
- SRT
- ES-HCM
- SCD
- HF-related death
- HT
- patients experiencing major adverse cardiac events (MACE)
- 38
- Septal reduction therapies (SRT)
- 9
- End-stage HCM (ES-HCM)
- 11
- Sudden cardiac death (SCD)
- 10
- HF/heart transplantation (HT)
- 8
Observational data: associations, not effects.
Further findings
Independent predictors of MACE (multivariable analysis)
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| PVO2% < 60 · multivariable analysis | 4.16 (1.89–9.14) | P < 0.001 | |
| NYHA Class >I · multivariable analysis | 2.27 (1.06–4.89) | P = 0.036 | |
| 0.10.31310Hazard ratio (log scale) |
Predictor of MACE with SRT as a competing risk
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| PVO2% < 60 · the only predictor of MACE · SRT as a competing risk | 3.966 (1.626–9.670) | P = 0.002 | |
| 0.10.31310Hazard ratio (log scale) |
Predictor of MACE among asymptomatic patients (NYHA Class I)
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| PVO2% < 60 · only significant predictor · also confirmed in the competing risk analysis | 5.611 (1.635–19.253) | P = 0.006 | |
| 0.050.21520Hazard ratio (log scale) |
Predictor of MACE among asymptomatic patients (NYHA Class I)
- risk divergence evident after nearly 15 years of follow-up
Original publication
Long-term prognostic value of cardiopulmonary exercise testing in patients with hypertrophic cardiomyopathy. ESC Heart Fail. Published 22 January 2026. doi:10.1093/eschf/xvag013
Summarised from the published abstract; every number is checked against it