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Mitral systolic velocity at peak exercise predicts impaired exercise capacity in patients with heart failure with preserved ejection fraction.
- Source :
- Echocardiography; Feb2017, Vol. 34 Issue 2, p217-225, 9p
- Publication Year :
- 2017
-
Abstract
- Background Nearly half of patients with heart failure have normal left ventricular ejection fraction ( LVEF), but their prognosis is no better than those with reduced LVEF. Although peak oxygen consumption ( VO<subscript>2</subscript>) is an independent predictor of mortality in heart failure, it is unclear how cardiac function during exercise contributes to peak VO<subscript>2</subscript>. Therefore, we explored the useful parameters measured by exercise stress echocardiography to predict peak VO<subscript>2</subscript> in patients with heart failure with preserved LVEF ( HFp EF). Methods and Results We assessed 80 patients being investigated for effort intolerance or dyspnea and finally analyzed 50 patients who satisfied the HFp EF criteria. Mean peak VO<subscript>2</subscript> was 16.4±2.8 mL/kg/min. Twenty-three patients (46.0%) achieved a peak VO<subscript>2</subscript> <16.0 mL/kg/min (Weber class C or D). There was a significant relationship between mitral systolic velocity (S′) and cardiac output ( CO) at rest ( R=.55, P<.0001) and peak exercise ( R=.64, P<.0001). The absolute increase in S′ from rest to peak exercise also correlated with the absolute increase in CO ( R=.32, P=.02). Multivariate logistic regression analysis showed that S′ at peak exercise independently predicted peak VO<subscript>2</subscript>. Receiver-operator characteristic curve analysis identified that an S′ at peak exercise of ≤8.13 cm/s predicted a peak VO<subscript>2</subscript> <16.0 mL/kg/min (sensitivity 95.7%, specificity 44.4%, area under curve 0.70, 95% confidence interval 0.55-0.84, P=.004). Conclusions Mitral systolic velocity at peak exercise accurately reflects peak VO<subscript>2</subscript> and may facilitate stratification of risk in patients with HFp EF. [ABSTRACT FROM AUTHOR]
- Subjects :
- HEART physiology
HEART failure
MITRAL valve
CARDIAC output
CARDIOPULMONARY system
CHI-squared test
CONFIDENCE intervals
STATISTICAL correlation
ECHOCARDIOGRAPHY
EXERCISE tests
FISHER exact test
CARDIAC contraction
LEFT heart ventricle
PROBABILITY theory
RISK assessment
T-test (Statistics)
MULTIPLE regression analysis
OXYGEN consumption
RECEIVER operating characteristic curves
DATA analysis software
DESCRIPTIVE statistics
EXERCISE tolerance
VENTRICULAR ejection fraction
PHYSIOLOGY
PROGNOSIS
Subjects
Details
- Language :
- English
- ISSN :
- 07422822
- Volume :
- 34
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Echocardiography
- Publication Type :
- Academic Journal
- Accession number :
- 121443917
- Full Text :
- https://doi.org/10.1111/echo.13440