Document Detail

Impact of changes in myocardial velocity assessed by tissue Doppler imaging during exercise on dynamic mitral regurgitation in patients with nonischemic cardiomyopathy.
MedLine Citation:
PMID:  18366355     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We evaluated the myocardial contractile reserve related to exercise-induced changes in functional mitral regurgitation (MR) by tissue Doppler imaging (TDI). METHODS: Supine bicycle exercise was performed in 35 patients with nonischemic cardiomyopathy (age 51 +/- 12 years; EF < 40%) and resting, and peak exercise 2D echocardiographic parameters, and TDI data were obtained. V(avg) was defined as the average of peak systolic velocities of six basal LV segments by TDI. Myocardial contractile reserve, which was calculated by [peak exercise V(avg)- baseline V(avg)], was represented as DeltaV(avg). Dyssynchrony index was derived from the standard deviation of the time to the peak systolic velocity of 12 LV segments. RESULTS: During exercise (9.7 +/- 2.4 minutes), the mean V(avg) increased from 4.0 +/- 0.8 cm/s to 5.5 +/- 1.0 cm/s. The effective regurgitant orifice area (ERO) and the ratio of MR jet area to the left atrial area (JLA%) were 1.9 +/- 2.9 mm(2) and 12 +/- 12%, respectively. During exercise, ERO and JLA% significantly increased to 6.2 +/- 6.4 mm(2) and 21 +/- 13% (P < 0.05), respectively, with individually variable changes. Tenting area was found to be an independent factor that showed a relationship with the baseline severity of MR (r = 0.561, P < 0.001). Dyssynchrony index and DeltaV(avg) were found to correlate with both maximal MR severity at peak exercise and changes in MR during exercise. By multivariate analysis, DeltaV(avg) was found to be an independent determinant of exercise-induced changes in ERO (DeltaERO; r =-0.707, P< 0.001) and changes in JLA% (DeltaJLA%; r =-0.663, P< 0.001). CONCLUSION: In patients with nonischemic cardiomyopathy, impaired contractile reserve assessed by TDI velocity data may be an independent determinant affecting exercise-induced changes in dynamic MR.
Soo-Jin Kang; Hong-Seok Lim; Jungwon Hwang; Jung-Hyun Choi; Kyoung-Woo Seo; Byung-Joo Choi; So-Yeon Choi; Gyo-Seung Hwang; Myeong-Ho Yoon; Joon-Han Shin; Seung-Jea Tahk
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Publication Detail:
Type:  Comparative Study; Journal Article    
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:  394-400     Citation Subset:  IM    
Division of Cardiology, Ajou University Hospital, Suwon, South Korea.
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MeSH Terms
Cardiomyopathies / complications*,  physiopathology,  ultrasonography
Echocardiography, Doppler / methods*
Exercise / physiology*
Exercise Test / methods*
Follow-Up Studies
Middle Aged
Mitral Valve Insufficiency / complications,  physiopathology*,  ultrasonography
Myocardial Contraction / physiology*
Prospective Studies
Severity of Illness Index

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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