Usefulness of the Evaluation of Left Ventricular Diastolic Function Changes During Stress Echocardiography in Predicting Exercise Capacity in Patients with Ischemic Heart Failure
Section snippets
Study Population
Our institutional review board approved the protocol and all patients gave written informed consent to participate in the study. The study group consisted of 50 consecutive patients with chronic, stable HF with the capability to perform the exercise test, referred to our echocardiography laboratory for a period of 9 months. HF was diagnosed according to the criteria proposed recently by the European Society of Cardiology.1 Clinical stability meant that there were no hospitalizations required as
Results
The demographics and clinical characteristics of the study group are presented in Table 1. All the patients performed stress echocardiography without chest pain, significant S-T changes, or echocardiographic evidence of inducible ischemia. We divided patients into two groups according to VO2peak value: group 1 consisted of 23 patients with VO2peak less than 14 mL/kg/min and group 2 consisted of 27 patients with VO2peak greater than or equal to 14 mL/kg/min. No significant differences were
Discussion
Resting parameters of systolic function, such as LV EF, are of limited value in predicting exercise tolerance but strong correlation was found between diastolic function and exercise tolerance.17, 18, 19 To optimize assessment of exercise performance our patients underwent a cardiopulmonary exercise test, taking measurements of VO2peak, which is currently still the gold standard in assessing functional capacity. We know that any cut-off value of VO2peak or any other spiroergometric parameter in
Conclusions
As has been previously described, many patients with HF, especially in the early stages, experience HF symptoms exclusively during exercise. Yet only resting parameters of systolic or diastolic function are assessed on a regular basis. Thus, the findings of this study suggest that identification of LV filling pressure, using E/E′ ratio at peak exercise, is more valuable than the resting assessment of E/E′ in predicting exercise capacity in patients with ischemic HF.
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