Document Detail

Relation of ventricular-vascular coupling to exercise capacity in ischemic cardiomyopathy: a cardiac multi-modality imaging study.
MedLine Citation:
PMID:  19823943     Owner:  NLM     Status:  MEDLINE    
The purpose of this study was to examine the relationship between noninvasive measurements of ventricular-vascular coupling (VVC) with exercise tolerance, and compared the value of VVC versus other traditional determinants of exercise capacity in this population. 43 patients with ischemic CMP (age 59 +/- 9 years, mean EF 24 +/- 8%) underwent cardiopulmonary exercise testing, echocardiography and cardiac magnetic resonance (CMR). VVC was defined non-invasively by the ratio of ventricular systolic elastance (Ees) to the arterial elastance (Ea), where Ees = end-systolic pressure/end-systolic volume index and Ea = end-systolic pressure/stroke volume index. VVC significantly correlated with baseline heart rate (HR), peak exercise systolic blood pressure, maximum oxygen consumption (MVO(2)) and peak O(2) pulse (MVO(2)/HR). A higher VVC was associated with higher LVEF and RVEF but showed inverse relation to mitral E wave velocity. Univariate predictors of MVO(2) are baseline HR, chronotropic reserve, VVC and aortic distensibility; whilst mitral E wave velocity, LVEF, VVC, Ees significantly correlated with peak O(2) pulse. By stepwise multivariate analysis, VVC remained the only independent predictor of peak O(2) pulse. Ventricular-vascular coupling at rest may be a clinically important parameter in predicting exercise capacity in patients with advanced heart failure, and may become an additional target for therapeutic interventions.
Raymond C Wong; Carlos A Dumont; Bethany A Austin; Deborah H Kwon; Scott D Flamm; James D Thomas; Randall C Starling; Milind Y Desai
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-10-13
Journal Detail:
Title:  The international journal of cardiovascular imaging     Volume:  26     ISSN:  1875-8312     ISO Abbreviation:  Int J Cardiovasc Imaging     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-08     Completed Date:  2010-04-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100969716     Medline TA:  Int J Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  151-9     Citation Subset:  IM    
Department of Cardiovascular Medicine/F15, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA,
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MeSH Terms
Aorta / physiopathology*
Cardiomyopathies / diagnosis,  etiology,  physiopathology*,  surgery
Echocardiography, Doppler, Color
Echocardiography, Doppler, Pulsed
Exercise Test
Exercise Tolerance*
Heart Failure / diagnosis,  etiology,  physiopathology*,  surgery
Heart Rate
Heart Transplantation
Magnetic Resonance Imaging
Middle Aged
Myocardial Ischemia / complications,  diagnosis,  physiopathology*,  surgery
Observer Variation
Oxygen Consumption
Predictive Value of Tests
Reproducibility of Results
Stroke Volume
Ventricular Function, Left*
Ventricular Function, Right
Ventricular Pressure
Comment In:
Int J Cardiovasc Imaging. 2010 Feb;26(2):161-4   [PMID:  19937127 ]

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