| Altered trans-mitral flow velocity pattern after exercise predicts development of new-onset atrial fibrillation in elderly patients with impaired left ventricular relaxation at rest: Prognostic value of diastolic stress echocardiography. | |
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MedLine Citation:
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PMID: 22218325 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: This study attempted to determine whether exercise induced left ventricular (LV) diastolic dysfunction estimated by altered trans-mitral flow (TMF) velocity pattern after exercise is associated with increased risk of cardiac events including new-onset atrial fibrillation (AF) in elderly patients with impaired LV relaxation at rest. BACKGROUND: Diastolic stress echocardiography has been applied to evaluate LV diastolic function during and post-exercise. Prognostic importance of exercise-induced diastolic dysfunction remains uncertain. PATIENTS AND METHODS: We studied 126 patients (70±5years; 70 males) who underwent treadmill stress echocardiography. Doppler measurements were done before exercise and immediately after the post-stress image acquisition, and the ratio between early (E) and atrial (A) TMF velocities was measured. Patients with impaired LV relaxation (E/A<1.0) at rest were studied. Altered TMF velocity pattern was present when patients with E/A<1.0 at rest developed E/A≥1.0 after exercise. Primary endpoints for follow-up were combination of major cardiac events and new-onset AF. RESULTS: There were 42 patients with altered TMF velocity pattern after exercise. During the 5-year follow-up period, there were 30 cardiac events including 13 new-onset AF. Kaplan-Meier survival plot demonstrated that altered TMF velocity pattern after exercise is associated with increased risk of cardiac events (p<0.0001) including development of new-onset AF (p=0.0003). Cox hazard ratio analysis demonstrated that altered TMF velocity pattern after exercise was the best predictor of cardiac events (hazard ratio 3.939; 95%confidence interval 1.662-9.337; p=0.0018). CONCLUSIONS: Altered TMF velocity pattern after exercise provides significant prognostic information for predicting cardiac events including new-onset AF in elderly patients with impaired left ventricular relaxation at rest. |
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Authors:
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Tsutomu Takagi; Atsushi Takagi; Junichi Yoshikawa |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-2 |
Journal Detail:
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Title: Journal of cardiology Volume: - ISSN: 1876-4738 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-5 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8804703 Medline TA: J Cardiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
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Takagi Cardiology Clinic, Kyoto, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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