The role of exercise echocardiography in the diagnostics of heart failure with normal left ventricular ejection fraction

Meluzı́n, Jaroslav; Sitar, Jan; Křístek, Jan; Prosecký, Robert; Pešl, Martin; Podroužková, Helena; Soška, Vladimír; Panovský, Roman; Dušek, Ladislav

doi:10.1093/ejechocard/jer082

Cited by 25 publications

(28 citation statements)

References 32 publications

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“…Echocardiographic analyses were performed by one experienced observer (JM), who was unaware of the PCWP values. The reproducibility of the transmitral pulsed Doppler and DTI velocities of this reader have already been published 8,9 , variabilities of E and e' velocities were below 5%.…”

Section: Echocardiographymentioning

confidence: 58%

Variability of post-exercise pulmonary capillary wedge pressure recovery. Implications for noninvasive echocardiographic diagnostics

Meluzı́n

Hude²,

Krejčí³

et al. 2015

BIOMED PAP

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Aim. The aim of our study was to assess the course of immediate post-exercise pulmonary capillary wedge pressure (PCWP) changes to identify the optimal time window for the noninvasive diagnostics of exercise-induced PCWP elevation. Methods and Results. Seventy-one patients at risk of heart failure with normal left ventricular ejection fraction underwent simultaneous exercise echocardiography and right heart catheterization. The ratio of early left ventricular filling velocity (E) to early diastolic mitral annular velocity (e') was used to predict noninvasively exercise-induced PCWP elevation. Fifty-one patients had exercise-induced PCWP elevation ≥ 8 mmHg and reached peak exercise PCWP ≥ 20 mmHg. Rapid post-exercise recovery of PCWP within 2 min was achieved in 18 (35.3%) patients. Intermediate postexercise PCWP recovery at 3 and 4 min was found in 16 (31.4%) patients while late post-exercise PCWP recovery (≥ 5 min) was achieved in 17 (33.3%) patients. Conclusion. The course of post-exercise PCWP recovery is highly variable, and a significant proportion of patients have only a brief period (≤ 2 min) of exercise-induced PCWP elevation. This fact should be taken into account in noninvasive assessment of exercise-induced PCWP.

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Section: Echocardiographymentioning

confidence: 58%

Variability of post-exercise pulmonary capillary wedge pressure recovery. Implications for noninvasive echocardiographic diagnostics

Meluzı́n

Hude²,

Krejčí³

et al. 2015

BIOMED PAP

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“…При физической нагрузке у здоровых лиц происходит закономерное изме-нение параметров трансмитрального кровотока и скоро-сти движения митрального кольца, которое выражается в увеличении скорости пика Е и пика е' пропорционально друг другу. У пациентов с повышением давления диасто-лического наполнения во время нагрузки происходит уве-личение скорости пика Е на фоне стабильно сниженной скорости пика е' [13]. Значение отношения Е / е' во время физической нагрузки, по данным ряда авторов, при пре-вышении 13 с чувствительностью 73 % и специфичностью 96 % указывает на повышение давления наполнения ЛЖ более 15 мм рт.…”

Section: Discussionunclassified

“…ст. [13,14]. Согласно рекомендациям по лечению и диагностике ХСН показанием для приме-нения диастолического стресс-теста является наличие у больного нарушения ДФ ЛЖ по псевдонормальному типу или по типу замедления релаксации, которое сопро-вождается выраженным ограничением нагрузки [2,15].…”

Section: Discussionunclassified

Opportunities of the echocardiography in prognosis of the left ventricular diastolic dysfunction in patients with hypertension

Обрезан¹,

Perutskiy²,

Perutskaya³

2017

RHJ

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“…sometimes even the combination of non-invasive tests is not sufficient to detect all patients with HFpeF (ref. 31 ) and exercise testing is necessary to diagnose the disease [32][33] . in patients with HFpeF a deterioration of longitudinal systolic function detected by 2d speckle tracking echocardiography is a far more accurate indicator of abnormal lV systolic function than reduced systolic mitral annular velocity evaluated by the doppler echocardiography 4 .…”

Section: Discussionmentioning

confidence: 99%

Longitudinal, circumferential and radial systolic left ventricular function in patients with heart failure and preserved ejection fraction

Gregorová¹,

Meluzı́n²,

Štěpánová³

et al. 2016

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Introduction. Heart failure with preserved left ventricular ejection fraction (HFPEF) is an epidemiologically serious disease. Noninvasive diagnosis of HFPEF remains challenging. The current diagnosis is based on evidence of diastolic dysfunction, albeit systolic dysfunction is also present but not included in the diagnostic algorithm. The aim of this study was to analyze the longitudinal (long), circumferential (circ) and radial (rad) component of systolic left ventricular (LV) function in patients with exertional dyspnea of unexplained etiology and normal left ventricular ejection fraction (LVEF). Methods. One hundred and twenty-two patients with exertional dyspnea of unexplained etiology and normal LVEF and 21 healthy controls, underwent echocardiography examination at rest and at the end of symptom-limited exercise. We analysed the longitudinal, circumferential and radial deformation of myocardium using two dimensional speckle tracking echocardiography in all subjects. Results. Patients with exertional dyspnea and preserved LVEF were divided into group A1 (46 patients meeting the criteria for the diagnosis HFPEF) and group A2 (76 patients without HFPEF). Group A1 had significantly worse longitudinal and circumferential systolic LV function than group A2. Subjects in group A1 compared to group A2 showed significantly different strain rates during atrial contraction (SR A), circ and ratio of peak early trans-mitral flow velocity (E) and strain rate E wave (E / SR E) circ. Multivariate logistic regression analysis showed that the SR parameter A circ is an independent predictor of HFPEF (odds ratio 0.550, 95% confidence interval: 0.370 -0.817, P value 0.003). Conclusion. Longitudinal and circumferential LV deformation was significantly more impaired in patients with HFPEF than in patients with exertional dyspnea without HFPEF. In patients with exertional dyspnea and normal LVEF, the value of SRA circ appears to be a significant and independent predictor of HFPEF. This parameter may, in the future complement the diagnostic algorithm for HFPEF.

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The role of exercise echocardiography in the diagnostics of heart failure with normal left ventricular ejection fraction

Abstract: A significant proportion of patients require exercise to diagnose HFNEF. Sa appears to be a significant independent predictor of HFNEF, which may increase the diagnostic value of models utilizing the variables recommended by the European Society of Cardiology guidelines.

Cited by 25 publications

References 32 publications

Variability of post-exercise pulmonary capillary wedge pressure recovery. Implications for noninvasive echocardiographic diagnostics

Variability of post-exercise pulmonary capillary wedge pressure recovery. Implications for noninvasive echocardiographic diagnostics

Opportunities of the echocardiography in prognosis of the left ventricular diastolic dysfunction in patients with hypertension

Longitudinal, circumferential and radial systolic left ventricular function in patients with heart failure and preserved ejection fraction

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