ArticleCirculation2023
The Prevalence and Association of Exercise Test Abnormalities With Sudden Cardiac Death and Transplant-Free Survival in Childhood Hypertrophic Cardiomyopathy.
Article in Circulation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Brazilian Guideline for Exercise Testing in Children and Adolescents - 2024.Arquivos brasileiros de cardiologia · 2024Guideline
- Therapeutic base editing alleviates restrictive cardiomyopathy.Cell reports. Medicine · 2026Article
- Physical activity and competitive sport safety for children affected by inherited cardiac conditions and selected acquired cardiomyopathies: emerging evidence and areas for further inquiry.European journal of pediatrics · 2026Review
- Exercise and Sport Participation in Pediatric Hypertrophic Cardiomyopathy: A Changing Paradigm.Current treatment options in cardiovascular medicine · 2026Review
- Impact of Neighborhood Factors on Exercise Capacity in Children With Hypertrophic Cardiomyopathy.Circulation. Heart failure · 2025Article
- Serial Exercise Testing in Children With Known or Suspected Congenital and Acquired Heart Disease: A Narrative Review and Survey of Current Practice.Journal of the American Heart Association · 2025Review
- The Cardiovascular Care of the Pediatric Athlete.Journal of the American College of Cardiology · 2025Review
- Electrocardiographic Findings in Genotype-Positive and Non-sarcomeric Children with Definite Hypertrophic Cardiomyopathy and Subclinical Variant Carriers.Pediatric cardiology · 2024Article
- Mechanisms of ischaemia-induced arrhythmias in hypertrophic cardiomyopathy: a large-scale computational study.Cardiovascular research · 2024Article
- Exploring Health-Related Quality of Life in Children With Hypertrophic Cardiomyopathy and Relationship to Physical Activity.Journal of the American Heart Association · 2024Observational
- Gene correction and overexpression of TNNI3 improve impaired relaxation in engineered heart tissue model of pediatric restrictive cardiomyopathy.Development, growth & differentiation · 2024Article
- Electrophysiological mechanisms underlying T wave pseudonormalisation on stress ECGs in hypertrophic cardiomyopathy.Computers in biology and medicine · 2024Article
- Effects of ranolazine on the arrhythmic substrate in hypertrophic cardiomyopathy.Frontiers in pharmacology · 2024Article
- Exercise-Induced Blood Pressure Dynamics: Insights from the General Population and the Athletic Cohort.Journal of cardiovascular development and disease · 2023Review
- Mechanisms and prognostic impact of myocardial ischaemia in hypertrophic cardiomyopathy.The international journal of cardiovascular imaging · 2023Review
- Exercise in Hypertrophic Cardiomyopathy: Recent Conceptual Changes and Recommendations for Pre-Exercise Tests.Reviews in cardiovascular medicine · 2023Review
- Contemporary review on pediatric hypertrophic cardiomyopathy: insights into detection and management.Frontiers in cardiovascular medicine · 2023Review
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Authors and funding
27 authors at 20 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHypertrophic cardiomyopathy (HCM) can be associated with an abnormal exercise response. In adults with HCM, abnormal results on exercise stress testing are predictive of heart failure outcomes. Our goal was to determine whether an abnormal exercise response is associated with adverse outcomes in pediatric patients with HCM.
methodsIn an international cohort study including 20 centers, phenotype-positive patients with primary HCM who were <18 years of age at diagnosis were included. Abnormal exercise response was defined as a blunted blood pressure response and new or worsened ST- or T-wave segment changes or complex ventricular ectopy. Sudden cardiac death (SCD) events were defined as a composite of SCD and aborted sudden cardiac arrest. Using Kaplan-Meier survival, competing outcomes, and Cox regression analyses, we analyzed the association of abnormal exercise test results with transplant and SCD event-free survival.
resultsOf 724 eligible patients, 630 underwent at least 1 exercise test. There were no major differences in clinical characteristics between those with or without an exercise test. The median age at exercise testing was 13.8 years (interquartile range, 4.7 years); 78% were male and 39% were receiving beta-blockers. A total of 175 (28%) had abnormal test results. Patients with abnormal test results had more severe septal hypertrophy, higher left atrial diameter
conclusionsExercise abnormalities are common in childhood HCM. An abnormal exercise test result was independently associated with lower transplant-free survival, especially in those with an ischemic or abnormal blood pressure response with exercise. Exercise-induced ischemia was also independently associated with SCD events. These findings argue for routine exercise testing in childhood HCM as part of ongoing risk assessment.
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