Document Detail


Coronary flow reserve as a link between diastolic and systolic function and exercise capacity in heart failure.
MedLine Citation:
PMID:  23169759     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIMS: In heart failure, a reduced exercise capacity is the prevailing symptom and an important prognostic marker of future outcome. The purpose of the study was to assess the relation of coronary flow reserve (CFR) to diastolic and systolic function in heart failure and to determine which are the limiting factors for exercise capacity. METHODS AND RESULTS: Forty-seven patients with left ventricular ejection fraction (LVEF) <35 [median LVEF 31 (inter-quartile range 26-34)] underwent cardiorespiratory exercise test with measurement of VO(2) peak, a dual X-ray absorptiometry scan for body composition, and a full echocardiography with measurement of LVEF using the biplane Simpson model, mitral inflow velocities, and pulsed wave tissue Doppler. Peak coronary flow velocity (CFV) was measured in the LAD, using pulsed-wave Doppler. CFR was calculated as the ratio between peak CFV at rest and during 2 min of adenosine stress.Fat-free-mass-adjusted VO(2) peak correlated significantly with CFR (r = 0.48, P = 0.002), E/e' (r = -0.35, P = 0.02), and s' (r = 0.45, P = 0.001) but not with LVEF (r = 0.23, P = 0.11). CFR correlated significantly with E/e' (r = -0.46, P = 0.003) and s' (r = 0.36, P = 0.02), but not with LVEF (r = 0.18, P = 0.26). When adjusting for CFR in a multivariable linear model, s' but not E/e' remained independently associated with VO(2) peak. CONCLUSION: In this group of heart failure patients, VO(2) peak was correlated with CFR, E/e', and s' but not with traditional measures of systolic function. CFR remained associated with VO(2) peak independently of diastolic and systolic function and is likely to be a limiting factor in functional capacity of heart failure patients.
Authors:
Martin Snoer; Tea Monk-Hansen; Rasmus Huan Olsen; Lene Roerholm Pedersen; Olav Wendelboe Nielsen; Hanne Rasmusen; Flemming Dela; Eva Prescott
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-20
Journal Detail:
Title:  European heart journal cardiovascular Imaging     Volume:  -     ISSN:  2047-2412     ISO Abbreviation:  Eur Heart J Cardiovasc Imaging     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101573788     Medline TA:  Eur Heart J Cardiovasc Imaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Cardiology, Bispebjerg University Hospital, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark.
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