Left Ventricular Diastolic Dysfunction and E/E ' Ratio as the Strongest Echocardiographic Predictors of Reduced Exercise Capacity After Acute Myocardial Infarction

• Type: Article in International Scientific Journal
• Date: 2015

Authors

Fontes-Carvalho R (Author) FMUP; Sampaio, F (Author) Other; Teixeira, M (Author) Other; Rocha Goncalves, F (Author) Other; Gama, V (Author) Other; Azevedo A (Author) FMUP; Leite-Moreira AF (Author) FMUP

Journal

Title: Clinical Cardiology

Vol. 38

Pages: 222-229

ISSN: 0160-9289

Publisher: Wiley-Blackwell

Indexing

ISI Web of Knowledge - 23 Citations

Scopus - 28 Citations

Other information

Authenticus ID: P-00A-CQ9

DOI: 10.1002/clc.22378

Abstract (EN): BackgroundThe mechanisms that determine reduced exercise capacity after acute myocardial infarction (AMI) are not fully understood, especially the relative role of left ventricular diastolic and systolic function. HypothesisTo evaluate the role of different diastolic and systolic function echocardiographic parameters as predictors of reduced functional capacity in patients after AMI. MethodsOne month after AMI, 225 patients (84% male; mean age, 55.110.9years) were enrolled and underwent detailed echocardiography and cardiopulmonary exercise test on the same day. Systolic and diastolic function was evaluated by echocardiography according to the latest consensus recommendations, including tissue Doppler evaluation. Exercise capacity was evaluated with peak oxygen consumption (VO2). ResultsPeak VO2 was significantly correlated with early diastolic tissue Doppler velocity (E) septal (r=0.42, P<0.001), E lateral (r=0.35, P<0.001), septal E/E ratio (r=-0.35, P=0.001), and lateral E/E (r=-0.27, P<0.001). These diastolic function parameters predicted impaired exercise capacity (VO2 <19 mL/kg/min), with an area under the receiver operating characteristic curve of 0.77 (95% confidence interval [CI]: 0.68-0.86, P<0.001) for septal E/E. On multivariate analysis, for each unit increase in septal E/E ratio there was a -0.35 (95% CI: -0.54 to -0.15) mL/kg/min decrease in peak VO2 independently of age, sex, body mass index, hypertension, and diabetes. There was a mild correlation between peak VO2 and systolic function parameters (r=0.17, P=0.01 with ejection fraction; and r=0.23, P=0.02 with lateral systolic tissue Doppler velocity) that persisted after multivariate adjustment. Conclusions<p id="clc22378-para-0004">After AMI, resting diastolic function parameters were the strongest correlates of exercise tolerance. Septal E/E ratio was the best echocardiographic predictor of reduced functional capacity.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8