Role of Diastolic Function in Preserved Exercise Capacity in Patients with Reduced Ejection Fractions - 01/10/15
, Hiroyuki Iwano, MD, PhD b, Vinay Thohan, MD c, Dalane W. Kitzman, MD d, Bharathi Upadhya, MD d, Min Pu, MD, PhD d, William C. Little, MD b, †Abstract |
Background |
Some patients with markedly reduced ejection fractions (EFs) (<35%) have preserved exercise performance greater than predicted for age and gender. Because diastolic function may be a determinant of exercise performance, this study was conducted to test the hypothesis that patients with preserved exercise tolerance despite EFs < 35% may have relatively normal diastolic function.
Methods |
Sixty-five subjects with EFs < 35% who underwent exercise Doppler echocardiography and had no inducible ischemia were retrospectively examined. Forty-five subjects with normal EFs (>60%) and preserved exercise capacity were analyzed as a control group.
Results |
Sixteen of 65 patients with EFs < 35% had greater than predicted normal exercise capacity for their age and gender, and the remaining 49 patients had reduced exercise capacity. Patients with reduced EFs and preserved exercise capacity had E/e′ ratios (mean, 10 ± 4) similar to those of control subjects (mean, 10 ± 3) and lower than those with reduced exercise tolerance (mean, 16 ± 8) (P < .01). In addition, they had better diastolic filling patterns and smaller left atrial sizes than patients with EFs < 35% and reduced exercise capacity. Multivariate logistic regression analyses indicated that E/e′ ratio was an independent predictor of preserved exercise capacity in patients with reduced EFs.
Conclusions |
Relatively intact diastolic function contributes to preserved exercise capacity in patients with reduced EFs (<35%).
Le texte complet de cet article est disponible en PDF.Keywords : Heart failure, Echocardiography, Diastole, Exercise
Abbreviations : BNP, BP, EF, HF, HFrEF, KLV, LV, SV, TAPSE, 2D
Plan
| This work was partially supported by an R21 grant from the National Institutes of Health (HL106276-01A1). Any opinions, findings, conclusions or recommendations expressed in this publication are those of the authors and do not necessarily reflect the views of the National Institutes of Health. The Wake Forest Translational Science Institute also provided financial support. |
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| Dr Little received consulting fees from Medtronic, CVRx, CorrAssist, and Cornovus. |
Vol 28 - N° 10
P. 1184-1193 - octobre 2015 Retour au numéro
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