BACKGROUND: Speckle tracking echocardiography is increasingly used to quantify left ventricular (LV) twist. However, one of the limitations of the assessment of LV twist by speckle tracking echocardiography is the crucial dependence on correct acquisition of a LV apical short-axis. This study sought to assess the influence of transducer position ...

AIMS: Plasma B-type natriuretic peptide (BNP) is an emerging biomarker in heart failure. In this setting, the extent of left ventricular (LV) dyssynchrony contributes to exercise symptoms. Whether exercise-induced changes in LV dyssynchrony might be a trigger of BNP release has never been investigated. METHODS AND RESULTS: Fifty-seven patients with ...

The myocardial performance index (MPI) has been proposed to be a simple echocardiographic index of right ventricular (RV) function in patients after surgical repair of tetralogy of Fallot (TOF). However, its functional status remains to be clarified. The functional implications of RV MPI were determined by exploring its relationships with ...

BACKGROUND: Functional mitral regurgitation (MR) is a powerful predictor of poor prognosis in patients with chronic heart failure (CHF) due to left ventricular systolic dysfunction (LVSD). However, severity of MR varies with dynamic exercise. Accordingly, we sought to assess the prognostic value of exercise-induced changes in functional MR in patients ...

BACKGROUND: It has been recently demonstrated that the hemodynamic consequences of exercise-induced increase in left ventricular (LV) filling pressure can be demonstrated noninvasively with supine bicycle exercise Doppler echocardiography. One of the practical drawbacks of Doppler echocardiography for assessing LV filling during exercise is the technical difficulty obtaining adequate signals ...

AIMS: To investigate the effects of exercise training (ET) on left ventricular (LV) volumes, cardiopulmonary functional capacity and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in postinfarction patients with moderate LV dysfunction. METHODS: Sixty-one postinfarction patients were randomized into two groups: group T [n=30, LV ejection fraction (EF) 41.6+/-11.3%, mean+/-SD] entered ...

An exaggerated increase in systolic blood pressure prolongs myocardial relaxation and increases left ventricular (LV) chamber stiffness, resulting in an increase in LV filling pressure. We hypothesize that patients with a marked hypertensive response to exercise (HRE) have LV diastolic dysfunction leading to exercise intolerance, even in the absence of ...

Bed rest deconditioning leads to physiological cardiac atrophy, which may compromise left ventricular (LV) filling during orthostatic stress by reducing diastolic untwisting and suction. To test this hypothesis, myocardial-tagged magnetic resonance imaging (MRI) was performed, and maximal untwisting rates of the endocardium, midwall, and epicardium were calculated by Harmonic Phase ...

BACKGROUND: Diastolic dysfunction and elevated left ventricular (LV) filling pressure at rest are key factors of exercise intolerance in patients with heart failure (HF). There are few studies, however, that have addressed the issue of changes of LV diastolic function and filling pressure during exercise in patients with HF with ...

AIMS: To determine whether elevated B-type natriuretic peptide (BNP) predicts left ventricular (LV) contractile dysfunction on exercise stress echocardiography in patients with severe mitral regurgitation (MR). METHODS AND RESULTS: Thirty three patients with moderate-to-severe or severe MR, a LV ejection fraction > or =60% and New York Heart Association Class ...

Tissue Doppler imaging-derived intra-left ventricular (LV) contractile dyssynchrony is an evolving prognostic parameter for patients with systolic heart failure (HF). However, whether and how exercise could abolish the synchronicity in HF patients with narrow QRS remains less studied. We evaluated a total of 33 HF patients with impaired LV ejection ...

To determine whether postischemic diastolic stunning could be detected using color kinesis, we evaluated regional left ventricular (LV) diastolic wall motion in 36 patients with stable effort angina and a coronary stenosis (> or = 70% of luminal diameter), and in 30 control subjects. Regional LV filling fraction in the ...

BACKGROUND: Patients with chronic heart failure (CHF) due to left ventricular systolic dysfunction (LVSD) may develop pulmonary hypertension at rest and during exercise. The cardiac correlates of pulmonary hypertension have been ascertained in the resting state, but seldom during exercise in these patients. AIMS: We sought to determine the cardiac ...

OBJECTIVES: There is still little information about the cardiorespiratory effects of cardiac resynchronization therapy (CRT) in patients undergoing all-day physical activity. This study aimed to assess the effects of CRT on ventilatory perfusion coupling during submaximal exercise. METHODS: Metabolic and hemodynamic parameters were obtained during treadmill exercise testing as well ...

BACKGROUND: Chordal cutting through atriotomy has been proposed to treat significant resting ischemic mitral regurgitation (MR) due to anterior leaflet tenting. In addition, MR may exacerbate during exercise not only trough exercise-induced ischemia but also through an increase in tenting area. Accordingly, we aimed to perform chordal cutting through aortotomy ...

BACKGROUND: In patients with idiopathic dilated cardiomyopathy (IDCM) a prolongation of left ventricular (LV) systole at the expense of diastolic time was demonstrated. Our study was aimed to evaluate the effect of exercise on heart rate corrected diastolic time in controls, IDCM with and without LBBB, and patients with LBBB ...

The aim of the present study was to quantify the left ventricular (LV) longitudinal motion during exercise at rest and during upright exercise in 24 healthy male endurance athletes. By using M-mode and two-dimensional echocardiography, the relative mitral annular motion and the absolute LV longitudinal axis was measured at end-diastole ...

BACKGROUND: The development of intra-ventricular gradients (IVG) during dobutamine or exercise stress is not infrequent, and can be associated to symptoms during stress. The purpose of this study was to assess the occurrence of IVG during exercise stress echocardiography in cardiac syndrome X patients. METHODS: We prospectively evaluated 91 patients ...

OBJECTIVE: Chronic dynamic exercise leads to regulative and structural adaptations of the heart (athlete's heart). To what extent the enlargement and physiologic hypertrophy of the heart lead to changes in the function of the valves, particularly regurgitation, is not yet clear. The aim of this study was to examine the ...

AIMS: The value of exercise echocardiography (EE) over resting echocardiography when this last incorporates information on mitral regurgitation (MR) is only partially known. Furthermore, limited data exist regarding the value of MR worsening during exercise in patients with left ventricular (LV) dysfunction. We investigate whether EE has incremental value over ...

AIMS: We investigated whether exercise training could promote angiogenesis and improve blood perfusion and left ventricular (LV) remodelling of the post-myocardial infarction (MI) failing heart. We also explored the contribution of ameliorated beta-adrenergic receptor signalling and function on the overall improvement of cardiac contractility reserve induced by exercise. METHODS AND ...

The increase in left ventricular (LV) end-diastolic volume has recently been shown to explain more than 70% of the increase in stroke volume during upright exercise in endurance athletes. As the end-diastolic volume enhancement not could be explained by an increase in axial cavity length an augmentation in LV short-axis ...

Ischemic mitral regurgitation is a complication of coronary artery disease specifically in the settings of prior myocardial infarction. It is a dynamic lesion and its severity may increase with different forms of exercise leading to flash pulmonary edema. We present the case of an 81-year-old man with ischemic mitral regurgitation ...

Exercise training and hypertension induced cardiac hypertrophy but modulate differently left ventricle (LV) function. This study set out to evaluate cardiac adaptations induced by moderate exercise training in normotensive and untreated severe hypertensive rats. Four groups of animals were studied: normotensive (Ctl) and severe hypertensive (HT) Wistar rats were assigned ...

BACKGROUND: Resting left ventricular outflow tract obstruction (LVOTO) occurs in 25% of patients with hypertrophic cardiomyopathy (HCM) and is an important cause of symptoms and disease progression. The prevalence and clinical significance of exercise induced LVOTO in patients with symptomatic non-obstructive HCM is uncertain. METHODS AND RESULTS: 87 symptomatic patients ...

OBJECTIVES: Left ventricular (LV) diastolic dysfunction is considered the earliest manifestation of diabetic cardiomyopathy. Whether LV abnormalities identified at rest by echocardiography predict peak exercise LV performance in uncomplicated type 1 diabetes mellitus (DM1) is largely unknown. RESEARCH DESIGN AND METHODS: We evaluated LV size, mass, and functions and peak ...

OBJECTIVE: To determine whether plasma levels of B-type natriuretic peptide (BNP) predict left ventricular (LV) dysfunction on exercise echocardiography in patients with moderate to severe aortic regurgitation (AR). DESIGN: Case-control study. SETTING: Outpatient cardiology departments. PATIENTS: 39 asymptomatic or mildly symptomatic patients with chronic moderate to severe AR and a ...

BACKGROUND: The present study sought to determine if echo-Doppler-derived pulmonary vascular resistance (PVR echo), net-atrioventricular compliance (Cn) and tricuspid peak systolic annular velocity (Sa), as parameters of right ventricular function, have value in predicting exercise capacity in patients with mitral stenosis (MS). METHODS AND RESULTS: Thirty-two patients with moderate or ...

BACKGROUND: On the basis of the close association of left atrial compliance with pulmonary hypertension in patients with mitral stenosis, we hypothesized that: (1) Doppler-derived net atrioventricular compliance (C(n)) can be used for predicting the occurrence of mitral valve (MV) replacement or percutaneous mitral commissurotomy (PMC); and (2) determinants of ...

BACKGROUND: While normal at rest, left ventricular (LV) systolic function may become abnormal during exercise in patients with aortic stenosis. Once contraindicated in patients with aortic stenosis, exercise testing is now recommended in asymptomatic patients with aortic stenosis to elicit symptoms and thereby ascertain the need for aortic valve replacement. ...

BACKGROUND: Many patients with repaired tetralogy of Fallot (TOF) have clinically important pulmonary regurgitation that can eventually lead to right ventricular (RV) dilatation and dysfunction and associated morbidity and mortality. Unfortunately, standard echocardiographic techniques to evaluate RV size and function can be inaccurate. Newer Doppler modalities such as Doppler tissue ...

We evaluated the effects of swimming and anabolic steroids (AS) on ventricular function, collagen synthesis, and the local renin-angiotensin system in rats. Male Wistar rats were randomized into control (C), steroid (S; nandrolone decanoate; 5 mg/kg sc, 2x/wk), steroid + losartan (SL; 20 mg.kg(-1).day(-1)), trained (T), trained + steroid (T+S), ...

Subglottic stenosis (SGS) is defined as the narrowing of the lower larynx. Difficulties in the management of subglottic stenosis, especially in the pediatric population, justify the development of experimental models. The objective of this study was to compare the two methods of experimental subglottic stenosis induction. Twenty-three dogs were randomly ...

Tissue Doppler imaging (TDI) is an echocardiographic technique used during exercising to improve the accuracy of a cardiovascular diagnostic. The validity of TDI requires its reproducibility, which has never been challenged during moderate to maximal intensity exercising. The present study was specifically designed to assess the transmitral Doppler and pulsed ...

Relative aldosterone excess is associated with endothelial dysfunction and higher incidence of end organ damage. We sought to investigate whether plasma aldosterone-to-renin ratio (ARR) is associated with left ventricular (LV) longitudinal function reserve to exercise in patients with controlled hypertension. In the patients with controlled and uncomplicated hypertension without overt ...

BACKGROUND: Professional, long-term physical training is often associated with morphological and metabolic changes in the heart. This study was undertaken to assess the left ventricular (LV) and right ventricular (RV) morphology and function and the LV high-energy phosphates of athletes trained to a sustained power or aerobic exercise. METHODS: Magnetic ...

In many heart diseases, exercise tolerance testing (ETT) has useful functional correlates and/or prognostic value. However, its predictive value in mitral regurgitation (MR) is undefined. To determine whether ETT descriptors predict death or indications for mitral valve surgery in patients with MR, we prospectively followed, for 7 +/- 3 end-point-free ...

OBJECTIVES: We hypothesize that the change in the left ventricular (LV) diastolic pattern (DP) may be measured with high reproducibility and correlates with exercise echocardiography (EE) better than the ratio of early LV inflow velocity to early diastolic annulus velocity (E/e' index). BACKGROUND: The E/e' index has been related to ...

Left ventricular hypertrophy (LVH) is associated with a reduction of subendocardial coronary flow reserve, which may be associated with abnormal myocardial longitudinal function during exercise. To test this hypothesis, 182 hypertensive patients underwent multistage supine bicycle exercise testing. Patients were classified as follows: patients with normal geometry (group 1, n ...

BACKGROUND: Corrected flow time (FTc) by oesophageal Doppler is considered to be a 'static' preload index. We evaluated the ability of FTc to predict fluid responsiveness and compared this with the abilities of other preload indices, such as pulse pressure variation (PPV), central venous pressure (CVP), and left ventricular end-diastolic ...

BACKGROUND: Anthracycline-treated patients (AP) are at risk for cardiac dysfunction years after treatment. Cardiac function has not been evaluated during exercise in AP. The purpose of this study was to assess exercise tolerance, left ventricular (LV) function, and hemodynamics during progressive exercise. PROCEDURE: We studied 47 AP (cumulative dose: 36-504 ...

Left ventricular (LV) systolic and diastolic parameters derived from Doppler echocardiography have been used widely to predict functional capacity but diastolic filling is affected by various factors. Tissue Doppler imaging (TDI) that records systolic and diastolic velocities within the myocardium and at the corners of the mitral annulus, has been ...

BACKGROUND: The aim of the study was to quantify the changes in cardiopulmonary function after minimally invasive video-assisted mitral valve repair for organic mitral regurgitation (MR) in asymptomatic or minimally symptomatic patients. METHODS: Twenty-six patients (age 54 +/- 11 years) with severe organic MR (regurgitant volume of 94 +/- 37 ...

BACKGROUND: Left ventricular diastolic dysfunction (DiaD) is as common as left ventricular systolic dysfunction. Whether these causes of heart failure lead to similar breathing pattern and gas exchange responses to exercise remains unclear. METHODS: Participants (control subjects [n = 47], systolic dysfunction [n = 46], and DiaD [n = 40]) ...

AIM: Patients with asymptomatic aortic stenosis (AS) and abnormal haemodynamic responses to exercise testing are at increased risk of cardiac events. This study assesses the Doppler echocardiographic determinants of a positive exercise test in a cohort of asymptomatic patients with AS. METHODS AND RESULTS: One hundred and twenty-eight patients with ...

BACKGROUND: Severity of mitral stenosis (MS) is assessed by means of mitral valve area and mean transmitral gradient. However, these conventional stenosis indexes poorly reflect the major hemodynamic consequence of MS, which is increase in pulmonary artery pressure (PAP). Valve resistance (VR) is a physiologic expression of stenosis because it ...

OBJECTIVES: We sought to assess the relationship between global Doppler myocardial imaging (DMI) and left ventricular (LV) ejection fraction (LVEF) at both rest and exercise. BACKGROUND: We have previously demonstrated that global DMI correlates with LVEF at rest with low variability. METHODS: LVEF by 2-dimensional echocardiography, systolic global tissue Doppler ...

AIMS: Exercise-induced mitral regurgitation (MR) bears a poor prognosis in patients with congestive heart failure (CHF). Cardiac resynchronization therapy (CRT) is associated with improved clinical outcome but its effects on exercise-induced MR remain undetermined. We investigated serial changes in functional MR in relation to left ventricular (LV) remodelling and cardiopulmonary ...

Mitral annular (MA) excursion during diastole encompasses a volume that is part of total left ventricular (LV) filling volume (LVFV). Altered excursion or area variation of the MA due to changes in preload or inotropic state could affect LV filling. We hypothesized that changes in LV preload and inotropic state ...

BACKGROUND: Doppler echocardiography is now used to evaluate left ventricular filling pressures in patients at rest. However, the clinical use of Doppler echocardiography in the determination of filling pressures with exercise has been less well studied. OBJECTIVE: The aim of this prospective study was to confirm the validity of an ...