| Noninvasive detection of exercise-induced markedly elevated left ventricular filling pressure by pulsed Doppler echocardiography in patients with coronary artery disease. | |
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MedLine Citation:
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PMID: 2816706 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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To assess the accuracy of the exercise-induced decrease in the ratio of peak flow velocity in atrial systole to that in early diastole (A/E) for predicting an elevation of left ventricular filling pressure, supine bicycle ergometer exercise testing was performed in 27 consecutive patients with coronary artery disease. Doppler-derived transmitral flow velocities were recorded at rest and immediately after exercise. A/E decreased during exercise in 16 patients (group A) and increased in 11 (group B). Pulmonary artery wedge pressure (PAWP) increased notably from 7 mm Hg at rest to 26 mm Hg at peak exercise in group A (p less than 0.001). In contrast, PAWP increased slightly from 6 mm Hg to 10 mm Hg in group B (p less than 0.05). The cardiac index at peak exercise in group A was significantly lower than that in group B (p less than 0.05). These findings suggest that patients with an exercise-induced decrease in A/E might not increase their cardiac output. A significant negative correlation between PAWP and A/E was observed in patients with PAWP over 20 mm Hg (r = -0.74; p less than 0.005). The exercise-induced decrease in A/E showed a sensitivity of 100%, a specificity of 73%, and a predictive accuracy of 85% in detecting patients with PAWP over 20 mm Hg. These findings show that Doppler recordings of transmitral flow velocities during dynamic exercise can provide useful information concerning exercise-induced left ventricular dysfunction associated with markedly elevated filling pressures. |
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Authors:
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M Iwase; M Yokota; M Maeda; S Kamihara; T Miyahara; M Iwase; H Hayashi; H Saito |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American heart journal Volume: 118 ISSN: 0002-8703 ISO Abbreviation: Am. Heart J. Publication Date: 1989 Nov |
Date Detail:
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Created Date: 1989-12-05 Completed Date: 1989-12-05 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 947-54 Citation Subset: AIM; IM |
Affiliation:
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First Department of Internal Medicine, Nagoya University School of Medicine, Japan. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cardiac Output Coronary Circulation* Coronary Disease / physiopathology* Diastole Echocardiography, Doppler* Exercise* Female Heart / physiopathology* Hemodynamics Humans Male Middle Aged Pulmonary Wedge Pressure Systole |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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