| Exercise testing in asymptomatic or minimally symptomatic aortic regurgitation: relationship of left ventricular ejection fraction to left ventricular filling pressure during exercise. | |
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MedLine Citation:
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PMID: 6299613 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Exercise radionuclide angiography is being used to evaluate left ventricular function in patients with aortic regurgitation. Ejection fraction is the most common variable analyzed. To better understand the rest and exercise ejection fraction in this setting, 20 patients with asymptomatic or minimally symptomatic severe aortic regurgitation were studied. All underwent simultaneous supine exercise radionuclide angiography and pulmonary gas exchange measurement and underwent rest and exercise measurement of pulmonary artery wedge pressure (PAWP) during cardiac catheterization. Eight patients had a peak exercise PAWP less than 15 mm Hg (group 1) and 12 had a peak exercise PAWP greater than or equal to 15 mm Hg (group 2). Group 1 patients were younger and more were in New York Heart Association class I. Group 1 patients also had a higher mean rest ejection fraction (0.64 +/- 0.08 vs 0.49 +/- 0.13, p less than 0.01, higher exercise ejection fraction (0.63 +/- 0.10 vs 0.40 +/- 0.18, p less than 0.01), lower end-systolic volume (38 +/- 13 vs 79 +/- 36 ml/m2, p less than 0.01) and higher peak oxygen uptake (24.9 +/- 5.1 vs 16.6 +/- 4.9 ml/kg/min, p less than 0.01) than group 2 patients. However, the two groups had similar cardiothoracic ratios, changes in ejection fractions with exercise, and rest and exercise regurgitant indexes. Using multiple regression analysis, the best correlate of the exercise PAWP was peak oxygen uptake (r = -0.78, p less than 0.01). No other measurement added significantly to the regression. When peak oxygen uptake was excluded, rest and exercise ejection fraction also correlated significantly (r = -0.62 and r = -0.60, respectively, p less than 0.01). Patients with asymptomatic or minimally symptomatic severe aortic regurgitation have a wide spectrum of cardiac performance in terms of the PAWP during exercise. The absolute rest and exercise ejection fraction and the level of exercise achieved are noninvasive variables that correlate with exercise PAWP in aortic regurgitation, but the change in ejection fraction with exercise by itself is not. |
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Authors:
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C A Boucher; R A Wilson; D J Kanarek; A M Hutter; R D Okada; R R Liberthson; H W Strauss; G M Pohost |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Circulation Volume: 67 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1983 May |
Date Detail:
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Created Date: 1983-05-27 Completed Date: 1983-05-27 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1091-100 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Age Factors Aged Aortic Valve Insufficiency / physiopathology*, radionuclide imaging Cardiac Output* Exercise Test* Female Heart Catheterization Heart Rate Heart Ventricles / physiopathology*, radionuclide imaging Humans Male Middle Aged Oxygen Consumption Pressure Pulmonary Gas Exchange Pulmonary Wedge Pressure Regression Analysis Sodium Pertechnetate Tc 99m Stroke Volume* Technetium / diagnostic use |
| Grant Support | |
ID/Acronym/Agency:
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26215//PHS HHS; HL 21751/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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23288-60-0/Sodium Pertechnetate Tc 99m; 7440-26-8/Technetium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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