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Heart failure with a preserved ejection fraction additive value of an exercise stress echocardiography.
MedLine Citation:
PMID:  22291430     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Heart failure (HF) with a preserved (P) left ventricular (LV) ejection fraction (EF) is common, though its diagnosis and physiopathology remains unclear. We sought to analyse the myocardial characteristics at rest and during a sub-maximal exercise test in patients with HFPEF. METHODS AND RESULTS: Standardized sub-maximal exercise stress echocardiography was performed in (i) 21 patients from the Karolinska Rennes Prospective Study of Heart Failure with Preserved Left Ventricular Ejection Fraction HFPEF registry, whose LVEF was ≥45% and (ii) 15 control patients free of any manifestations of HF. During a sub-maximal exercise test, LV systolic function measured as a global four-chamber longitudinal strain was -17 ± 5% in patients with HFPEF vs. -22 ± 4% in controls (P < 0.001), LV longitudinal diastolic relaxation, expressed as e' (septal and lateral walls averaged) was 9 ± 2 cm/s in patients vs. 15 ± 4 cm/s in controls (P < 0.001), and RV longitudinal systolic function, expressed as RV s', was 14 ± 3 cm/s in patients vs. 18±1 cm/s in controls (P = 0.03). LV afterload (arterial elastance) was 2.7 ± 1 mmHg/mL and was correlated with a decrease in LV longitudinal strain (R = 0.51, P < 0.01) during exercise. CONCLUSION: The assessment of longitudinal systolic and diastolic LV and RV functions is valuable during a sub-maximal exercise stress echocardiography to confirm the heart dysfunction related to the HFPEF symptoms. It might be used as a diagnostic test for difficult clinical situations.ClinicalTrials.gov identifier: NCT01091467.
Authors:
Erwan Donal; Christophe Thebault; Lars H Lund; Gaëlle Kervio; Amelie Reynaud; Tabasomne Simon; Elodie Drouet; Emilie Nonotte; Cecilia Linde; Jean-Claude Daubert
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-29
Journal Detail:
Title:  European heart journal cardiovascular Imaging     Volume:  -     ISSN:  2047-2412     ISO Abbreviation:  Eur Heart J Cardiovasc Imaging     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-31     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, Pontchaillou University Hospital, 2 Rue Henri Le Guilloux, 35033 Rennes, France.
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