Diastolic Intra-Left Ventricular Pressure Difference During Exercise: Strong Determinant and Predictor of Exercise Capacity in Patients With Heart Failure

被引：7

作者：

Tsujinaga, Shingo ^{[1
,2
]}

Iwano, Hiroyuki ^{[1
,2
]}

Sarashina, Miwa ^{[1
,2
]}

Hayashi, Taichi ^{[1
,2
]}

Murayama, Michito ^{[3
]}

Ichikawa, Ayako ^{[4
]}

Nakabachi, Masahiro ^{[4
]}

Nishino, Hisao ^{[4
]}

Yokoyama, Shinobu ^{[4
]}

Fukushima, Arata ^{[1
,2
]}

Yokota, Takashi ^{[1
,2
]}

Okada, Kazunori ^{[5
]}

Kaga, Sanae ^{[5
]}

Vlachos, Pavlos P. ^{[6
]}

Anzai, Toshihisa ^{[1
,2
]}

机构：

[1] Hokkaido Univ, Fac Med, Dept Cardiovasc Med, Sapporo, Hokkaido, Japan

[2] Hokkaido Univ, Grad Sch Med, Sapporo, Hokkaido, Japan

[3] Hokkaido Univ Hosp, Diagnost Ctr Sonog, Sapporo, Hokkaido, Japan

[4] Hokkaido Univ Hosp, Div Clin Lab & Transfus Med, Sapporo, Hokkaido, Japan

[5] Hokkaido Univ, Fac Hlth Sci, Sapporo, Hokkaido, Japan

[6] Purdue Univ, Sch Mech Engn, W Lafayette, IN 47907 USA

来源：

JOURNAL OF CARDIAC FAILURE | 2019年 / 25卷 / 04期

关键词：

Heart failure; exercise capacity; exercise-stress echocardiography; intra-left ventricular pressure difference; STRESS ECHOCARDIOGRAPHY; AEROBIC CAPACITY; GRADIENTS;

D O I：

10.1016/j.cardfail.2019.02.005

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Although the enhancement of early-diastolic intra-left ventricular pressure difference (IVPD) during exercise is considered to maintain exercise capacity, little is known about their relationship in heart failure (HF). Methods and Results: Cardiopulmonary exercise testing and exercise-stress echocardiography were performed in 50 HF patients (left ventricular [LV] ejection fraction 39 +/- 15%). Echocardiographic images were obtained at rest and submaximal and peak exercise. Color M-mode Doppler images of LV inflow were used to determine IVPD. Thirty-five patients had preserved exercise capacity (peak oxygen consumption [VO2] >= 14 mL.kg(-1).min(-1); group 1) and 15 patients had reduced exercise capacity (group 2). During exercise, IVPD increased only in group 1 (group 1: 1.9 +/- 0.9 mm Hg at rest, 4.1 +/- 2.0 mm Hg at submaximum, 4.7 +/- 2.1 mm Hg at peak; group 2: 1.9 +/- 0.8 mm Hg at rest, 2.1 +/- 0.9 mm Hg at submaximum, 2.1 +/- 0.9 mm Hg at peak). Submaximal IVPD (r = 0.54) and peak IVPD (r = 0.69) were significantly correlated with peak VO2. Peak IVPD determined peak VO2 independently of LV ejection fraction. Moreover, submaximal IVPD could well predict the reduced exercise capacity. Conclusion: Early-diastolic IVPD during exercise was closely associated with exercise capacity in HF. In addition, submaximal IVPD could be a useful predictor of exercise capacity without peak exercise in HF patients.

引用

页码：268 / 277

页数：10

共 21 条

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