Document Detail

Cardiac correlates of exercise induced pulmonary hypertension in patients with chronic heart failure due to left ventricular systolic dysfunction.
MedLine Citation:
PMID:  18177381     Owner:  NLM     Status:  MEDLINE    
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 correlates of exercise induced pulmonary hypertension in patients with LVSD by monitoring the estimated pulmonary artery systolic pressure (PASP) by continuous Doppler echocardiography during semirecumbent bicycle exercise. METHODS: Eighty-five patients (mean age 57 +/- 13 years, 75% male) with CHF due to LVSD (LV ejection fraction [EF] <45%, mean LVEF 26 +/- 8%) were studied. RESULTS: Mitral effective regurgitant orifice area and E-wave were independent predictors of resting PASP. Resting PASP and exercise induced changes in PASP were unrelated (r =-0.08, P = 0.45). Decrease in LV end-systolic volume, increase in left atrial (LA) area, resting LV asynchrony, and decreased tricuspid annular plane systolic excursion (TAPSE) were independent predictors of exercise PASP. CONCLUSIONS: Resting LV asynchrony, impaired LV contractile reserve, and increase in LA dilatation correlate with the severity of exercise induced pulmonary hypertension in patients with CHF due to LVSD, while right ventricular systolic dysfunction is inversely related to the severity of exercise induced pulmonary hypertension.
Sylvestre Maréchaux; Claire Pinçon; Thierry Le Tourneau; Pascal de Groote; Clémence Huerre; Philippe Asseman; Eric Van Belle; Rémi Nevière; Christophe Bauters; Ghislaine Deklunder; Thierry H Lejemtel; Pierre V Ennezat
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-01-03
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  25     ISSN:  0742-2822     ISO Abbreviation:  Echocardiography     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-27     Completed Date:  2008-08-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  386-93     Citation Subset:  IM    
Physiology Department, Centre Hospitalier Régional et Universitaire de Lille, Lille, France.
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MeSH Terms
Chronic Disease
Disease Progression
Echocardiography, Doppler / methods
Exercise Test / adverse effects*
Heart Failure / complications*,  physiopathology,  ultrasonography
Hypertension, Pulmonary / etiology*,  physiopathology,  ultrasonography
Middle Aged
Risk Factors
Severity of Illness Index
Stroke Volume / physiology
Ventricular Dysfunction, Left / complications*,  physiopathology,  ultrasonography
Ventricular Pressure / physiology

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