| Prognostic implications of left ventricular filling pressure with exercise. | |
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MedLine Citation:
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PMID: 20233862 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The estimation of left ventricular (LV) filling pressure from the ratio of transmitral and annular velocities (E/e') after exercise echocardiography may identify diastolic dysfunction in patients who complain of exertional dyspnea. This study sought to determine the relative contributions of exercise E/e' and ischemia to outcomes in patients referred for exercise echocardiography. METHODS AND RESULTS: Rest and exercise E/e' were obtained in 522 patients referred for exercise echocardiography, who were followed for cardiovascular death and hospitalization over a median of 13.2 months. Exercise E/e' >2 SD from normal was used to denote raised LV filling pressure with stress (n=75), and ischemia (n=250) was identified by inducible wall motion abnormalities. There were 65 cardiovascular hospitalizations during the follow-up period. Survival analysis showed patients without ischemia and with normal exercise E/e' to have a better prognosis than those with ischemia, with or without raised exercise E/e' (P=0.003) and the outcomes of patients with isolated raised exercise E/e' and isolated ischemia to be similar. Exercise E/e' was most valuable in patients with normal resting E/e'; those with elevation with exercise had a worse outcome than those with normal exercise E/e' (P=0.014). Exercise capacity (hazard ratio, 0.893; P=0.008), exercise wall motion score index (hazard ratio, 1.507; P<0.001), and exercise E/e' >14.5 (hazard ratio, 2.988; P=0.002) were independent predictors of outcome. The addition of exercise E/e' to exercise capacity and wall motion score index resulted in an increment in model power to predict adverse outcome (P=0.006). CONCLUSIONS: Exercise E/e' is associated with cardiovascular hospitalization, independent of and incremental to inducible ischemia. |
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Authors:
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David J Holland; Sandhir B Prasad; Thomas H Marwick |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Circulation. Cardiovascular imaging Volume: 3 ISSN: 1942-0080 ISO Abbreviation: Circ Cardiovasc Imaging Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-17 Completed Date: 2010-05-07 Revised Date: 2010-09-21 |
Medline Journal Info:
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Nlm Unique ID: 101479935 Medline TA: Circ Cardiovasc Imaging Country: United States |
Other Details:
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Languages: eng Pagination: 149-56 Citation Subset: IM |
Affiliation:
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School of Medicine, The University of Queensland, Brisbane, Australia. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Chi-Square Distribution Coronary Angiography Diastole Dyspnea / etiology, physiopathology Echocardiography, Stress* Exercise Test Exercise Tolerance Female Humans Male Middle Aged Myocardial Ischemia / physiopathology, ultrasonography Prognosis Proportional Hazards Models Survival Analysis Ventricular Dysfunction, Left / physiopathology*, ultrasonography* Ventricular Pressure* |
| Comments/Corrections | |
Comment In:
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Circ Cardiovasc Imaging. 2010 Sep 1;3(5):e3
[PMID:
20841551
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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