BACKGROUND: Current guidelines recommend mitral valve surgery for asymptomatic patients with severe degenerative mitral regurgitation and preserved left ventricular systolic function when exercise pulmonary hypertension (PHT) is present. However, the determinants of exercise PHT have not been evaluated. The aim of this study was to identify the echocardiographic predictors of ...

BACKGROUND: The influence of right ventricular (RV) function on exercise capacity has been poorly explored in mitral stenosis (MS). The objective of this study was to assess the determinants of functional status with exercise echocardiography in MS. METHODS: Thirty-nine patients (55 +/- 12 years, 29 female) with MS (1.3 +/- ...

BACKGROUND: Increase of left atrial (LA) diameter in trained athletes has been regarded as another component of the "athlete's heart". AIMS: To evaluate the possible impact of competitive training on LA volume and to define reference values of LA volume index in athletes. METHODS AND RESULTS: Six hundred fifteen consecutive ...

Myocardial hypertrophy and dysfunction occur in response to excessive catecholaminergic drive. Adverse cardiac remodelling is associated with activation of proinflammatory cytokines in the myocardium. To test the hypothesis that exercise training can prevent myocardial dysfunction and production of proinflammatory cytokines induced by beta-adrenergic hyperactivity, male Wistar rats were assigned to ...

OBJECTIVES: To test whether symptoms revealed on exercise testing in patients with moderate or severe aortic stenosis are associated with changes in left ventricular systolic function and to investigate the ability of resting measures to predict peak cardiac index. METHODS: In a prospective study of asymptomatic aortic stenosis, 38 patients ...

Parameters of diastolic function have been shown to correlate with exercise capacity (EC) in individuals with impaired left ventricular (LV) systolic function. However, the role of LV diastolic function in predicting EC in Chagas cardiomyopathy has not been reported. OBJECTIVES: This study aimed to determine the relationship between LV diastolic ...

The aim of this study was to investigate physiological and clinical consequences of percutaneous pulmonary valve implantation (PPVI) in patients with chronic right ventricular outflow tract (RVOT) obstruction and volume overload. The PPVI is a nonsurgical technique to address RVOT conduit dysfunction. Twenty-eight adolescents (median age 14.9 years; age range ...

BACKGROUND: The aim of this study was to evaluate if left ventricular (LV) systolic function by tissue Doppler echocardiography at rest and during exercise preoperatively could predict postoperative LV function and thereby be useful in the timing of aortic valve surgery in patients with severe aortic regurgitation. METHODS: In 29 ...

BACKGROUND: Mechanisms behind exercise-induced increase of mitral regurgitation (MR) in patients with chronic ischemic heart disease have been described earlier. We describe the determinants of exercise-induced changes in MR in patients with non-ST-elevation acute coronary syndrome (NSTACS). METHODS: Forty-five consecutive patients (mean + or - SD age 64 + or ...

Aims Abnormal exercise test defined as the occurrence of exercise limiting symptoms, fall in blood pressure below baseline, or complex ventricular arrhythmias is useful to predict clinical events in asymptomatic patients with aortic stenosis (AS). The purpose of this study was to determine whether exercise-stress echocardiography (ESE) adds any incremental ...

Right ventricular (RV) dysfunction is an important factor on effort tolerance in cardiopulmonary diseases. Nevertheless, the role of RV function in predicting exercise capacity in patients with Chagas disease has not been reported. This study aims to evaluate whether RV function assessed by tissue Doppler can predict functional capacity in ...

Marfan syndrome (MS) is a dominant autosomal disease caused by mutations in chromosome 15, the locus controlling fibrillin 1 synthesis, and may exhibit skeletal, ocular, cardiovascular, and other manifestations. Pulse wave velocity (PWV) is used to measure arterial elasticity and stiffness and is related to the elastic properties of the ...

Endurance-trained individuals exhibit larger reductions in left ventricular (LV) end-diastolic volume in response to lower body negative pressure (LBNP) compared with normally active individuals. However, the relationship between LV torsion and untwisting and the LV volume response to LBNP in endurance athletes is unknown. Eight endurance-trained athletes [maximal oxygen consumption ...

To determine the prevalence of polycystic ovary syndrome (PCOS) in women who exercise regularly. All women under age 45 from an industrial company who had past history of exercising more than 6 months enrolled in this cross-sectional study. Prevalence of PCOS and comparison of BMI between PCOS and non-PCOS subgroups ...

BACKGROUND: Left atrial volume and exercise capacity are strong predictors of cardiovascular risk. Decreased exercise capacity is expected when LAV is increased due to its association with abnormal left ventricular filling pressure. However, LAV enlargement is expected in chronic mitral regurgitation as well. OBJECTIVES: To examine the link between LAV ...

The management of asymptomatic patients with severe aortic stenosis is challenging. Unfortunately, evaluation of symptoms such as dyspnoea remains subjective. The use of exercise echocardiography may help to predict major events in patients with asymptomatic severe aortic stenosis. This article explains how to perform the test and discusses which echocardiographic ...

Abdominal aortic aneurysms (AAAs) affect 5-7% of older Americans. We hypothesize that exercise may slow AAA growth by decreasing inflammatory burden, peripheral resistance, and adverse hemodynamic conditions such as low, oscillatory shear stress. In this study, we use magnetic resonance imaging and computational fluid dynamics to describe hemodynamics in eight ...

This study investigated the association between invasive and non-invasive estimates of left ventricular (LV) filling pressure and exercise capacity, in order to find new potential candidates for risk markers in severe aortic valve stenosis (AS). Twenty-nine patients with AS, aortic valve area (AVA) < 1 cm(2), performed a symptom-limited multistage ...

To evaluate the relation of echocardiographic parameters of diastolic function, exercise capacity (expressed as peakVO(2)) and NT-proBNP in patients with transposition of the great arteries (TGA) and Mustard procedure. Diastolic function was determined by measuring tricuspid flow velocities (Ea/Aa ratio), isovolumic relaxation time (IVRT), and deceleration time (DT). E/Ea ratios ...

OBJECTIVES: We explored the incremental value of quantification of tissue Doppler (TD) velocity during the brief isovolumic contraction (IVC) phase of the cardiac cycle for the prediction of exercise performance in patients referred for cardiopulmonary exercise testing (CPET). BACKGROUND: Experimental studies have shown that rapid left ventricular (LV) shape change ...

OBJECTIVE: Increased levels of C-reactive protein (CRP) are associated with left ventricular (LV) hypertrophy. This association may be causal (either directly or indirectly) or simply a confounder resulting from the recognized relationship between CRP and vascular disease. We attempted to clarify this issue, by assessing the association of a variant ...

BACKGROUND: The initiation of ventricular diastole is an energy-dependent phase of cardiac cycle. Delayed onset of left ventricular (LV) relaxation has been proposed to identify myocardial ischemia. Diabetes mellitus (DM) is known to be associated with coronary microangiopathy, but its influence on LV early relaxation is not established. METHODS AND ...

Exercise testing has an established role in the evaluation of patients with valvular heart disease and can aid clinical decision making. Because symptoms may develop slowly and indolently in chronic valve diseases and are often not recognized by patients and their physicians, the symptomatic, blood pressure, and electrocardiographic responses to ...

We report here the worsening of functional mitral regurgitation (MR) during dynamic exercise Doppler echocardiography in four female patients with heart failure and preserved ejection fraction. MR worsened concomitantly to an increase in systolic mitral tenting area and in E/E(a) ratio, whereas local left ventricular (LV) remodelling was not substantially ...

Recent studies have demonstrated the usefulness of biochemical markers of collagen turnover as markers of myocardial fibrosis in various diseases. In this study, we hypothesized that increased collagen markers in patients with hypertrophic cardiomyopathy (HCM) were correlated with diastolic function at rest and diastolic functional reserve during exercise. Thirty-six patients ...

Exercise training has been shown to be effective in improving exercise capacity and quality of life in patients with heart failure and left ventricular (LV) systolic dysfunction. Real-time myocardial contrast echocardiography (RTMCE) is a new technique that allows quantitative analysis of myocardial blood flow (MBF). The aim of this study ...

We examined the effect of intensity during prolonged exercise (PE) on left (LV) and right ventricular (RV) function. Subjects included 18 individuals (mean +/- SE: age = 28.1 +/- 1.1 yr, maximal aerobic power = 55.1 +/- 1.6 ml . kg(-1) . min(-1)), who performed 150 min of exercise at ...

Mitral regurgitation (MR) is the second most common valvular disease in western countries after aortic stenosis. Optimal management of patients with MR depends on the etiology of the regurgitation and is based predominantly on left ventricular function and functional status. Recent outcome studies report high risk subsets of asymptomatic patients ...

We assessed the time delay from the onset of QRS (Q) to peak systolic (S') and diastolic (E') tissue velocities in the left (LV) and right ventricle (RV) before and after prolonged exercise. Nineteen well-trained runners (mean +/- SD age, 41 +/- 9 years) had tissue-Doppler echocardiography performed before and ...

Left ventricular (LV) diastolic function is important because the enhanced systolic function that underpins high levels of cardio-respiratory fitness has to be matched by changes in LV filling, and LV diastolic dysfunction plays a key early role in the development and progression of a myriad of cardiovascular diseases. This review ...

OBJECTIVES: We sought to determine the mechanisms linking dynamic obstruction and exercise tolerance in patients with hypertrophic obstructive cardiomyopathy (HOCM). BACKGROUND: Patients with HOCM have reduced exercise tolerance. However, the association between dynamic obstruction and peak oxygen consumption (VO2max) is weak. METHODS: We enrolled 25 patients with HOCM, 20 with ...

AIMS: Left ventricular (LV) shape and LV dyssynchrony are two cofactors associated with functional mitral regurgitation (MR) in patients with heart failure. Both can be accurately examined by real-time three-dimensional echocardiography (3DE). We examined the relationship between dynamic MR and exercise-induced changes in LV shape and synchronicity using 3DE. METHODS ...

Patients with congenitally corrected transposition of the great arteries (ccTGA) have significantly reduced exercise tolerance. Progressive right ventricular (RV) dysfunction with tricuspid regurgitation (TR) and other haemodynamic lesions are common among them. We hypothesised that interaction of these factors may result in increased systemic RV filling pressure, which in turn ...

Osteogenic dynamic loads delivered to the skeleton during exercise prevent aging-associated bone fragility. Moreover, because of its pleiotropic favourable effects on health, exercise improves quality of life, and specific types of exercise increase muscle strength, a known predictor of bone strength, and coordination and balance, and so reduce the risk ...

Blood (or plasma) rheology is related to cardiovascular risk. Mechanisms of this association are unclear but may be partially related to impaired left ventricular (LV) function and increased central blood pressure (BP) during light activity. This study aimed to test these hypotheses. Twenty patients (14 men; aged 61+/-12 years) with ...

BACKGROUND: Aortic valve replacement with a cryopreserved aortic homograft (CH) is an attractive alternative to bioprosthesis implantation. The aim of the study was to compare the hemodynamic performance of CH implanted with aortic root inclusion compared to prototype stentless (SS) bioprosthesis, standard stented (SD) bioprosthesis, and a native aortic valve. ...

Six minute walking test (6-MWT) may serve as a reproducible test for assessing exercise capacity in heart failure (HF) patients and can be clinically predicted. We aimed in this study to ascertain if global markers of ventricular asynchrony can predict 6MWT distance in a group of patients with HF and ...

BACKGROUND: The role of left atrial (LA) function on exercise remains poorly understood in heart failure with preserved ejection fraction (HfpEF) despite its key role in optimizing left ventricular (LV) diastolic function. We used resting and exercise radionuclide ventriculography to investigate the role of LA function in the pathophysiology of ...

BACKGROUND: Frequent ventricular ectopic beats (VEB) in patients without significant cardiac disease are usually classified as benign arrhythmia. However, they may alter cardiac performance. RF ablation can effectively eliminate VEB. AIM: To evaluate the effects of RF ablation on selected haemodynamic parameters of left ventricular (LV) systolic and diastolic function ...

The purpose of this study was to examine the effects of the self-contained breathing apparatus (SCBA) on left-ventricular (LV) function at rest and during mild- to moderate-intensity exercise, using 2-dimensional echocardiography. Twenty-three healthy male volunteers exercised on a stair-climber at work rates equivalent to 50%, 60%, 70%, and 80% of ...

To examine the effect of aerobic training in mitigating trastuzumab-mediated left ventricular (LV) remodeling in women with human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Seventeen women (53 +/- 7 years) with HER2-positive breast cancer did aerobic training during the first 4 months of adjuvant trastuzumab. Peak oxygen consumption ...

BACKGROUND: Whether echo-Doppler-derived index of ventricular elastance or ventriculoarterial interaction can reliably reflect circulatory efficiency in various conditions was investigated in the present study and whether they can be helpful in predicting exercise capacity in patients with dilated cardiomyopathy (DCM). METHODS AND RESULTS: The 25 patients with DCM, 25 age- ...

Left ventricular (LV) hypertrophy is a well-established, but highly variable, finding among exercise-trained persons. The causes for the variability in LV remodeling in response to exercise training remain incompletely understood. The present study sought to determine whether a family history of hypertension is a determinant of the cardiac response to ...

BACKGROUND AND AIM: There are several studies on myocardial tissue Doppler velocities during dobutamine stress, but few studies on the same parameters during bicycle exercise. We wanted to examine how sample sites affected velocities, beat-to-beat variability and segments eligible for analysis. METHODS: Twenty patients with normal coronary arteries were included ...

OBJECTIVE: To assess autograft, homograft and ventricular function, as well as exercise capacity, in adult patients who have undergone the Ross procedure. SETTING: Single centre paediatric and adult congenital heart disease unit. Patients 45 subjects (24.6 years, range 16.9-52.2 years) who underwent the Ross procedure between 1994 and 2006 (8.1 ...

BACKGROUND: Exercise training has beneficial effects in patients with heart failure, although there is still no clear evidence that it may impact on their survival. There are no data regarding the effects of exercise in subjects with chronic left ventricular (LV) volume overload. Using a rat model of severe aortic ...

BACKGROUND: Aortic valve regurgitation (AR) imposes a pathologic volume overload to the left ventricle (LV), whereas aerobic exercise causes physiologic volume overloading. The impact of combining both LV volume overloads (pathologic and physiologic) is unknown. Considering the known beneficial effects of aerobic training on the cardiovascular system, we hypothesized that ...

BACKGROUND: Response of systolic and diastolic velocities of mitral annulus to exercise in patients with subclinical hypothyroidism (SCH) has not been explored previously. We sought to investigate whether SCH is associated with abnormal left ventricular (LV) longitudinal function reserve to exercise. METHODS: Mitral annular systolic (S') and early diastolic (E') ...

BACKGROUND: Numerous studies have reported evidence of cardiac injury associated with transient left ventricular (LV) systolic and diastolic dysfunction after prolonged and strenuous exercise. We used 2D ultrasound speckle tracking imaging to evaluate the effect of an ultralong-duration exercise on LV regional strains and torsion. We speculated that systolic dysfunction ...

Previous investigations have established the prognostic value of variables obtained from both echocardiography with tissue Doppler Imaging (TDI) and cardiopulmonary exercise testing (CPX) in patients with heart failure (HF). Past prognostic comparisons of variables obtained from these evaluation techniques have been limited to the comparison of left ventricular ejection fraction ...