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Left ventricular ma...
Left ventricular markers of global dyssynchrony predict limited exercise capacity in heart failure, but not in patients with preserved ejection fraction
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- Bajraktari, Gani (author)
- Umeå universitet,Kardiologi
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Batalli, Arlind (author)
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Poniku, Afrim (author)
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Ahmeti, Artan (author)
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Olloni, Rozafa (author)
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Hyseni, Violeta (author)
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Vela, Zana (author)
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Morina, Besim (author)
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Tafarshiku, Rina (author)
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Vela, Driton (author)
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Rashiti, Premtim (author)
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Haliti, Edmond (author)
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- Henein, Michael Y (author)
- Umeå universitet,Kardiologi,Heart centre
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(creator_code:org_t)
- 2012-09-11
- 2012
- English.
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In: Cardiovascular Ultrasound. - : BioMed Central. - 1476-7120. ; 10, s. 36-
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Abstract
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- Background: The aim of this study was to prospectively examine echocardiographic parameters that correlate and predict functional capacity assessed by 6 min walk test (6-MWT) in patients with heart failure (HF), irrespective of ejection fraction (EF).Methods: In 147 HF patients (mean age 61 +/- 11 years, 50.3% male), a 6-MWT and an echo-Doppler study were performed in the same day. Global LV dyssynchrony was indirectly assessed by total isovolumic time - t-IVT [in s/min; calculated as: 60 - (total ejection time + total filling time)], and Tei index (t-IVT/ejection time). Patients were divided into two groups based on the 6-MWT distance (Group I: <= 300 m and Group II: > 300 m), and also in two groups according to EF (Group A: LVEF >= 45% and Group B: LVEF <45%).Results: In the cohort of patients as a whole, the 6-MWT correlated with t-IVT (r = -0.49, p < 0.001) and Tei index (r = -0.43, p < 0.001) but not with any of the other clinical or echocardiographic parameters. Group I had lower hemoglobin level (p = 0.02), lower EF (p = 0.003), larger left atrium (p = 0.02), thicker interventricular septum (p = 0.02), lower A wave (p = 0.01) and lateral wall late diastolic myocardial velocity a' (p = 0.047), longer isovolumic relaxation time (r = 0.003) and longer t-IVT (p = 0.03), compared with Group II. In the patients cohort as a whole, only t-IVT ratio [1.257 (1.071-1.476), p = 0.005], LV EF [0.947 (0.903-0.993), p = 0.02], and E/A ratio [0.553 (0.315-0.972), p = 0.04] independently predicted poor 6-MWT performance (< 300 m) in multivariate analysis. None of the echocardiographic measurements predicted exercise tolerance in HFpEF.Conclusion: In patients with HF, the limited exercise capacity, assessed by 6-MWT, is related mostly to severity of global LV dyssynchrony, more than EF or raised filling pressures. The lack of exercise predictors in HFpEF reflects its multifactorial pathophysiology.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Six-minute walk test
- Doppler echocardiography
- LV function and dyssynchrony
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Bajraktari, Gani
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Batalli, Arlind
-
Poniku, Afrim
-
Ahmeti, Artan
-
Olloni, Rozafa
-
Hyseni, Violeta
-
show more...
-
Vela, Zana
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Morina, Besim
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Tafarshiku, Rina
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Vela, Driton
-
Rashiti, Premtim
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Haliti, Edmond
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Henein, Michael ...
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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Cardiovascular U ...
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Umeå University