A patient with severe, symptomatic hypertrophic cardiomyopathy (HCM) without a significant left ventricular outflow tract (LVOT) gradient at rest requires further evaluation. During exercise echocardiography (EE) performed on a supine bicycle, a latent or underestimated dynamic obstruction may be identified in real time, with postprandial assessment being particularly relevant.
Hemodynamic Impact of Hypertrophic Cardiomyopathy at Rest and During Supine Bicycle Exercise: Additional Value of Postprandial Assessment
AbreuMEB, DiógenesTCP, ChagasISM, XerexHM, AbreuJSD. Hemodynamic Impact of Hypertrophic Cardiomyopathy at Rest and During Supine Bicycle Exercise: Additional Value of Postprandial Assessment. ABC Imagem Cardiovasc. 2026;39(1):e20250049.
Abreu,Marília Esther Benevides; Diógenes,Tereza Cristina Pinheiro; Chagas,Isadora Sucupira Machado; Xerex,Humberto Mororó; Abreu,José Sebastião De. Hemodynamic Impact of Hypertrophic Cardiomyopathy at Rest and During Supine Bicycle Exercise: Additional Value of Postprandial Assessment. ABC Imagem Cardiovasc., v. 39, n. 1, e20250049, Mar. 2026.
Abreu,M.E.B., Diógenes,T.C.P., Chagas,I.S.M., Xerex,H.M., & Abreu,J.S.D. (2026). Hemodynamic Impact of Hypertrophic Cardiomyopathy at Rest and During Supine Bicycle Exercise: Additional Value of Postprandial Assessment. ABC Imagem Cardiovasc.,39(1), e20250049.
Abreu,Marília Esther Benevides and Diógenes,Tereza Cristina Pinheiro and Chagas,Isadora Sucupira Machado and Xerex,Humberto Mororó and Abreu,José Sebastião De. Hemodynamic Impact of Hypertrophic Cardiomyopathy at Rest and During Supine Bicycle Exercise: Additional Value of Postprandial Assessment. ABC Imagem Cardiovasc. [online]. 2026, vol. 39, n. 1, [cited 2026-04-23], e20250049. Available from: <https://www.abcimaging.org/article/hemodynamic-impact-of-hypertrophic-cardiomyopathy-at-rest-and-during-supine-bicycle-exercise-additional-value-of-postprandial-assessment/>. ISSN .
Figure 1
– Structural and functional characterization in hypertrophic cardiomyopathy: coronary computed tomography angiography and multimodal echocardiographic assessment. A) Coronary computed tomography angiography – three-dimensional reconstruction showing the LMCA and its branches (anterior view); B) coronary computed tomography angiography – three-dimensional reconstruction showing epicardial coronary arteries and branches (complementary view); C) transthoracic echocardiography in two-dimensional and M-mode demonstrating myocardial morphology and wall thickening; D) transthoracic echocardiography in two-dimensional and M-mode with additional assessment of ventricular dynamics; E) echocardiography with atrial volumetric quantification (biplane method); F) LV GS analysis (polar map/bull’s-eye). AD: left anterior descending artery; Cx: circumflex artery; Dg1: first diagonal branch; Dg2: second diagonal branch; Dg3: third diagonal branch; GS: global longitudinal strain; LA: left atrium; LMCA: left main coronary artery; LV: left ventricle; Mg1: first marginal branch (obtuse marginal); Mg2: second marginal branch (obtuse marginal); Mg3: third marginal branch (obtuse marginal); PD: posterior descending artery; PV: posterior ventricular branch; RA: right atrium; RCD: right coronary artery; RV: right ventricle.