Document Detail

Incremental value of left ventricular diastolic function reserve index for predicting exercise capacity in patients with hypertrophic cardiomyopathy.
MedLine Citation:
PMID:  17904804     Owner:  NLM     Status:  MEDLINE    
The changes of left ventricular diastolic function during exercise are heterogeneous in patients with hypertrophic cardiomyopathy (HCM). We sought to investigate whether exertional changes of mitral annular velocities and plasma N-terminal-pro-B-type natriuretic peptide (BNP) concentration are associated with exercise capacity in patients with HCM. After a comprehensive echocardiographic study, 32 patients with HCM performed symptom-limited graded supine bicycle exercise. Echocardiographic Doppler parameters were measured at each stage of exercise. Blood samples were collected at rest and immediately after exercise to determine the concentration of pro-BNP. Resting pro-BNP (r = -0.620, P < .001), E'(base) (r = 0.414, P = .018), and DeltaE'(50W) (change of E' from base to 50 W of exercise) (r = 0.367, P = .039) were significantly correlated with exercise duration. Left ventricular longitudinal diastolic function reserve index, defined as DeltaE' x E'(base), significantly correlated with exercise duration (at 50 W, r = 0.540, P = .001) independent of age, sex, body mass index, and resting pro-BNP level. When combining DeltaE' x E'(50W) (<5.85 cm(2)/s(2)) and resting pro-BNP (>740 mg/dL), the predictive accuracy for exercise capacity could be improved (for <500 seconds, global chi(2) = 5.84 in pro-BNP vs 8.10 in pro-BNP + DeltaE' x E'(50W), P = .023). The assessment of left ventricular longitudinal diastolic function reserve can provide incremental information to pro-BNP for the prediction of exercise capacity in patients with HCM.
Eui-Young Choi; Jong-Won Ha; Se-Joong Rim; Sung-Ai Kim; Se-Jung Yoon; Chi-Young Shim; Jin-Mi Kim; Yangsoo Jang; Namsik Chung; Seung-Yun Cho
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-09-29
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  21     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-05     Completed Date:  2008-06-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  487-92     Citation Subset:  IM    
Cardiology Division, Yonsei Cardiovascular Center and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
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MeSH Terms
Cardiomyopathy, Hypertrophic / blood,  complications,  ultrasonography*
Echocardiography / methods*
Exercise Test
Exercise Tolerance*
Fractional Flow Reserve, Myocardial*
Image Interpretation, Computer-Assisted / methods*
Middle Aged
Natriuretic Peptide, Brain / blood
Peptide Fragments / blood
Reproducibility of Results
Sensitivity and Specificity
Ventricular Dysfunction, Left / blood,  etiology,  ultrasonography*
Reg. No./Substance:
0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain

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