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Relationship between echocardiographic parameters and exercise test duration in patients after myocardial infarction
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Abstract
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 (∆At; 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 ∆At (Art–At).
Conclusions: Diastolic parameters showing the strongest correlation with ED (∆At 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 ∆At.
Abstract
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 (∆At; 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 ∆At (Art–At).
Conclusions: Diastolic parameters showing the strongest correlation with ED (∆At 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 ∆At.
Keywords
echocardiography; diastolic dysfunction; exercise test duration; heart failure
About this articleTitle
Relationship between echocardiographic parameters and exercise test duration in patients after myocardial infarction
Journal
Issue
Pages
507-513
Published online
2009-11-19
Page views
632
Article views/downloads
854
DOI
10.5603/cj.21433
Bibliographic record
Cardiol J 2009;16(6):507-513.
Keywords
echocardiography
diastolic dysfunction
exercise test duration
heart failure
Authors
Karina Wierzbowska-Drabik
Maria Krzemińska-Pakuła
Michał Plewka
Jarosław Drożdż
Małgorzata Kurpesa
Ewa Trzos
Tomasz Rechciński
Łukasz Chrzanowski
Jarosław D. Kasprzak
