Role of Advanced Testing: Invasive Hemodynamics, Endomyocardial Biopsy, and Cardiopulmonary Exercise Testing

Authors

Gregg M. Lanier, New York Medical CollegeFollow
John T. Fallon, New York Medical CollegeFollow
Srihari S. Naidu, New York Medical CollegeFollow

Journal Title

Cardiology Clinics

First Page

73

Last Page

82

Document Type

Article

Publication Date

February 2019

Department

Medicine

Abstract

Hypertrophic cardiomyopathy affects 0.5% of the population. Advanced testing is considered, including cardiac catheterization, endomyocardial biopsy, and cardiopulmonary exercise testing. Right and left heart catheterization provides essential hemodynamic data, identifies patients who might benefit from septal reduction therapy, and assesses for comorbidities. Pathologic analysis reveals ventricular hypertrophy, myocardial disarray, and endocardial and interstitial fibrosis. Routine endomyocardial biopsy is not recommended unless other conditions that cause hypertrophy need to be ruled out. Cardiopulmonary exercise testing provides useful physiologic data, allows monitoring of the response to medication and surgical interventions, estimates prognosis, and guides referral for orthotopic heart transplantation.

Recommended Citation

Lanier, G. M., Fallon, J., & Naidu, S. (2019). Role of Advanced Testing: Invasive Hemodynamics, Endomyocardial Biopsy, and Cardiopulmonary Exercise Testing. Cardiology Clinics, 37 (1), 73-82. https://doi.org/10.1016/j.ccl.2018.08.010