Close Coupling of Systolic and Diastolic Function: Combined Assessment Provides Superior Prediction of Exercise Capacity

The Growing Problem of Obesity and the Heart

“…This finding makes the case that the abnormalities seen on tissue Doppler imaging are clinically relevant. Moreover, the present results reinforce the notion that the ejection fraction (of either ventricle) is an insensitive measure of systolic dysfunction, whereas tissue Doppler measurements are more sensitive for detecting such abnormalities (12,13). In addition, the high signal-to-noise ratio of tissue Doppler measurements makes them easier to record, relatively simple to quantify, and very reproducible as compared with approaches that require clear endocardial visualization.…”

Tissue Doppler Image-Derived Measurements During Isovolumic Contraction Predict Exercise Capacity in Patients With Reduced Left Ventricular Ejection Fraction

“…Previous studies have correlated TD-derived parameters like early diastolic lengthening velocities (Ea) and E/Ea ratio with the extent of exercise limitation in patients with reduced LVEF (25)(26)(27)(28). Recent investigations have further suggested the combined use of systolic ejection and early diastolic TD parameter, rather than isolated measurements, would be essential for proper characterization of the extent of exercise intolerance (29). The duration of the total isovolumic period is a major determinant of peak VO 2 (30,31).…”

Real Time Three-Dimensional Stress Echocardiography: A New Approach for Assessing Diastolic Function

“…[1][2][3][4][5][6] Despite data demonstrating the value of evaluating diastolic function during stress, 7 left ventricular diastolic function is routinely assessed at rest even in patients with exertional symptoms. This association between diastolic dysfunction and exertional symptoms is independent of left ventricular systolic function and has been demonstrated in patients with both normal and abnormal systolic function.…”

“…[1][2][3][4][5][6] Despite the presence of exertional symptoms and data demonstrating the value of evaluating diastolic function during stress, 7 left ventricular diastolic function is routinely assessed at rest, rather than during stress. [1][2][3][4][5][6] Despite the presence of exertional symptoms and data demonstrating the value of evaluating diastolic function during stress, 7 left ventricular diastolic function is routinely assessed at rest, rather than during stress.…”