Reversal of Inappropriate Peripheral Vascular Responses in Hypertrophic Cardiomyopathy

Abstract

Paradoxical vasodilatation during LBNP occurs in 40% of patients with ABPR during exercise and is reversed by propranolol, clonidine, and paroxetine. Paroxetine also improved SBP response to exercise.

Increased B-type natriuretic peptide is associated with an abnormal blood pressure response to exercise in asymptomatic aortic stenosis

“…Beta-blockers could influence heart rate and blood pressure during exercise, and plasma levels of BNP [22][23][24]. However study findings were similar before and after statistical adjustment for betablocker treatment, and when patients taking beta-blockers were excluded from the analysis.…”

Relation of Pulse Pressure to Blood Pressure Response to Exercise in Patients With Hypertrophic Cardiomyopathy

“…excessive fall in peripheral/systemic vascular resistance) 19 . It has also been suggested that lower exercise capacity and ABPR in HC may be related to diastolic dysfunction 20 and a blunted augmentation of stroke volume during exercise 21 .…”

The Science of Uncertainty and the Art of Probability

“…The recent demonstration of recurrent abrupt spontaneous episodes of hypotension during daily activities associated with a fall in systemic vascular resistance suggests that abnormal vascular control mechanisms may also explain some episodes of non-exercise-related syncope. 11 Data on tilt testing in patients with hypertrophic cardiomyopathy and syncope are relatively scant. In 1 small study, head-up tilt at 60°for 45 minutes resulted in a fall in mean arterial pressure and reflex hypotension in 82% of syncopal patients compared with 26% of nonsyncopal patients and 22% of control subjects.…”