The influence of diastolic and systolic function on exercise performance in heart failure due to dilated cardiomyopathy or ischemic heart disease

Background: Peripheral adaptations and ventricular abnormalities influence physical performance in chronic heart failure. However, the role of the heart in determining exercise capacity has not been completely elucidated. Aims: To define cardiac determinants of exercise capacity in patients with dilated cardiomyopathy. Methods: In 101 patients with heart failure (NYHA class II–III) due to primary or ischemic dilated cardiomyopathy we measured peak exercise oxygen consumption (Pvo2), left ventricular ejection fraction (EF), left and right atrial and ventricular cavity dimensions, mitral and tricuspid flows. Patients were subdivided in class A (Pvo2>20 ml/min per kg; n=44), class B (Pvo2 16–20 ml/min per kg; n=42) and class C (Pvo2