Factors influencing the variations of ejection fraction during exercise in chronic aortic regurgitation

Abstract

The influence of left ventricular volume variations and regurgitant fraction variations upon left ventricular ejection fraction during exercise was examined using equilibrium radionuclide angiography in patients suffering from aortic regurgitation. Ejection fraction (EF), regurgitant fraction (RF), end diastolic volume (EDV) and end systolic volume (ESV) variations from rest to peak exercise were determined in 44 patients suffering from chronic aortic regurgitation (AR) and in 8 healthy volunteers (C). In C, EF increased (+0.10 +/- 0.03, P less than 0.01) and ESV decreased significantly (-23% +/- 12%, P less than 0.01), RF and EDV did not vary significantly. In AR patients, EF, EDV and ESV did not vary significantly because of important scattering of individual values. Changes in EF and ESV were inversely correlated (r = -0.79, P less than 0.01) and RF decreased significantly (-0.12 +/- 0.10, P less than 0.01). Volumes and EF changes during exercise occurred in three different ways. In a 1st subgroup of 7 patients, EF increased (+0.09 +/- 0.03, P less than 0.05) in conjunction with a reduction of ESV (-24% +/- 12%, P less than 0.05) without a significant change in EDV. In a 2nd group of 22 patients, EF decreased (-0.04 +/- 0.07, P less than 0.01) in association with an increase in ESV (+17% +/- 16%, P less than 0.01) and no change in EDV. In a 2nd group of 22 patients, EF decreased (-0.04 +/- 0.07, P less than 0.01) in association with an increase in ESV (+17% +/- 16%, P less than 0.01) and no change in EDV. In a 3rd subgroup of 15 patients, EF decreased (-0.02 +/- 0.06, P less than 0.01) despite a reduction in ESV (-7% +/- 6%, P less than 0.01) because of a dramatic EDV decrease (-10% +/- 6%, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Exercise Radionuclide Ventriculography for Predicting Post-Operative Left Ventricular Function in Chronic Aortic Regurgitation

“…Furthermore, these variables had predictive value for the risk of sudden cardiac death in the natural history of the disease (3). In the present study, pre-operative EF rest was found to be significantly correlated to EF max , separately both pre-and postoperatively, which was in concordance with previous studies (7,11,25,26). However, pre-operative EF rest was not connected to post-operative EF increase upon exercise and was, therefore, not found to be informative for LV performance during exercise post-operatively.…”

Measurement of physical work capacity in patients with chronic aortic regurgitation: a potential improvement in patient management

“…Optimal timing of surgery in chronic aortic regurgitation (AR) remains a challenge. (Bassand et al. , 1987; Bonow, 1994, 2000; Borer et al.…”