Exercise capacity in patients with coronary artery disease: what is beyond global left ventricular systolic function?

• Type: Summary of Presentation in an International Conference
• Date: 2012

Authors

Correia AS (Author) Other; Gonçalves A (Author) Other; Rocha A (Author) Other; Costa S (Author) Other; Guilherme F (Author) Other; Paiva M (Author) Other; Sousa A (Author) Other; Araújo V (Author) Other; Pereira F (Author) Other; Maciel MJ (Author) FMUP

Conference proceedings International

Title: European Heart Journal

Pages: 662-663

ESC Congress 2012

Munich, 25 a 29 de Agosto de 2012

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Abstract (EN): Purpose: Exercise capacity is influenced by multiple factors and elucidating the mechanisms for cardiac-related exercise limitation has been technically difficult. In this study we sought to determine the effect of cardiac function on exercise capacity. Methods: Prospective study including patients admitted to an outpatient cardiac rehabilitation program (CRP) after suffering an acute coronary event between January 2011 and September 2011. Echocardiography data and exercise capacity were evaluated at the beginning and at the end of the CRP. All echocardiographic measurements were performed according to current guidelines and exercise capacity assessed by estimated metabolic equivalents (METs) achieved on exercise stress testing. Results: Forty-five patients were evaluated, 38 (84%) male, mean age of 54 (±9) years. Among these, 19 (42%) were dyslipidemic, 7 (16%) diabetic, 13 (29%) hypertensive, 20 (44%) were overweight, and 24 (53%) were current smokers. Regarding echocardiography baseline group analysis, left ventricle ejection fraction (LVEF) was 55±9%, left atrial volume was 51±15 cm3, E/E' ratio was 9±3 and left ventricular TDI peak systolic velocity (medium between septum and lateral basal wall longitudinal movements) was 8.8±2.0 cm/seg. Exercise capacity at CRP beginning was 9.5±2.2 METs and correlated inversely with E/E' ratio (r=-0.440, p=0.009) and left atrial volume (r=-0.385, p=0.022). A positive correlation between exercise capacity and left ventricular peak systolic velocity (r=0.359, p=0.04) was found while no correlation was observed with LVEF. Correlation between exercise capacity and E/E' or LV peak systolic velocity remained significant after adjustment to other possible confounding factors, as age, gender, weight and diabetes, which can also influence exercise capacity. E/E' and left atrial volume at the admission were also inversely correlated with functional status at the end of the CRP (r=-0.517, p=0.004; r=-0.489, p=0.006 respectively). Conclusions: Higher LV filling pressures may influence negatively the exercise capacity as demonstrated by the inverse correlation found between peak METs level and diastolic parameters: E/E' and left atrial volume. Although regional LV systolic function also correlated with exercise capacity, global LV function did not. These results suggest that the evaluation of sensitive parameters of left ventricle function may help to better clarify the influence of cardiac function in exercise performance.

Language: English

Type (Professor's evaluation): Scientific

Notes: Correia AS, Gonçalves A, Rocha A, Costa S, Guilherme F, Paiva M, Sousa A, Araújo V, Pereira F, Maciel MJ. Exercise capacity in patients with coronary artery disease: what is beyond global left ventricular systolic function? Eur Heart J 2012; 33 (Abstract Suppl): 662-663