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Relationship between echocardiographic parameters and exercise test duration in patients after myocardial infarction.
MedLine Citation:
PMID:  19950086     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: The interdependence between echocardiographic parameters of left ventricle function, severity of heart failure (HF) and exercise test duration has not been thoroughly examined. METHODS: We compared echocardiographic data in patients after myocardial infarction divided according to NYHA class to mild (class I and II, group 1 = 24 subjects) and advanced HF group (III and IV, group 2 = 36) and assessed their correlation with exercise duration (ED) in a symptom-limited treadmill test. Then we tried to determine independent predictors of ED. RESULTS: The group with advanced HF had lower left ventricle ejection fraction, shorter duration and deceleration times of both mitral inflow waves (Et and At, Edt and Adt) and higher E/A ratio (1.4 +/- 1.1 vs. 0.9 +/- 0.4; p < 0.05) with more frequent restriction and pseudonormalization pattern (56% vs. 12%). Also early wave propagation (21 +/- 7 vs. 29 +/- 11 cm/s; p < 0.001) and all tissue Doppler velocities were lower, but ratio of early wave peak velocity to early diastolic velocity of mitral annulus was higher (E/E' 10.5 +/- 5 vs. 6.1 +/- 1.3 for velocity ratio; p < 0.001) in subjects with more severe clinical symptoms. Significant negative correlation with ED was observed for difference between duration of pulmonary vein atrial reversal flow and atrial wave of mitral inflow (DeltaAt; r = -0.54) and for E/E' ratio (r = -0.48), the highest positive correlation for left ventricular ejection fraction and duration of mitral inflow atrial phase (EF; r = 0.48, At; r = 0.46). In multivariate stepwise regression analysis two independent predictors of ED were identified: age and DeltaAt (Art-At). CONCLUSIONS: Diastolic parameters showing the strongest correlation with ED (DeltaAt and E/E') are connected with restrictive left ventricle physiology. The only independent predictors of exercise duration in patients after myocardial infarction were: age and DeltaAt.
Authors:
Karina Wierzbowska-Drabik; Maria Krzemińska-Pakuła; Michał Plewka; Jarosław Drozdz; Małgorzata Kurpesa; Ewa Trzos; Tomasz Rechciński; Lukasz Chrzanowski; Jarosław D Kasprzak
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiology journal     Volume:  16     ISSN:  1897-5593     ISO Abbreviation:  -     Publication Date:  2009  
Date Detail:
Created Date:  2009-12-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101392712     Medline TA:  Cardiol J     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  507-13     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Medical University of Łódź, Poland. wierzbowska@ptkardio.pl
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