Tissue Doppler–Derived Contractile Reserve Is a Simple and Strong Predictor of Cardiopulmonary Exercise Performance across a Range of Cardiac Diseases

Abstract

There is a very strong relationship between measurements of S' during exercise and exercise capacity. The previously observed poor correlation with standard measures of systolic and diastolic cardiac function may be explained both by the load dependence of parameters such as ejection fraction and by reliance on resting as opposed to exercise assessment.

Contractile reserve and cardiopulmonary exercise parameters in patients with dilated cardiomyopathy, the two dimensions of exercise testing

“…We showed that resting LVEF is a relatively poor correlate of peak VO 2 and ventilatory efficiency, although, as expected by the Fick equation, CO was the strongest correlate of peak VO 2 along with previous validated predictors of peak VO 2 including age, sex, and BMI . These findings are similar to a 2013 study by McIntosh et al., including patients with medically treated HFrEF (n=28), who reported a strong correlation with CO. However, they did not show a significant correlation between resting LV metrics and peak VO 2 .…”

Coronary Flow Reserve Predicts Cardiopulmonary Fitness in Patients with Coronary Artery Disease Independently of Systolic and Diastolic Function

“…3,20,21 In this study, s′ showed a stronger correlation with VO 2 peak than LVEF, perhaps because an average of s′ from 4 points in the mitral ring is a more robust marker of global systolic function than LVEF measured using biplane Simpson. 3,20,21 In this study, s′ showed a stronger correlation with VO 2 peak than LVEF, perhaps because an average of s′ from 4 points in the mitral ring is a more robust marker of global systolic function than LVEF measured using biplane Simpson.…”

“…Studies of traditional markers of resting systolic cardiac function have found no or poor correlation with VO 2 peak in both heart failure and CAD, 3,5 but recent studies show that tissue Doppler systolic function (s′) is associated with VO 2 peak. 3,20,21 In this study, s′ showed a stronger correlation with VO 2 peak than LVEF, perhaps because an average of s′ from 4 points in the mitral ring is a more robust marker of global systolic function than LVEF measured using biplane Simpson. Diastolic function parameters, especially E/e′, show a strong association with VO 2 peak in both heart failure patients and patients with CAD and normal LVEF.…”

“…Median CFR was 2.22 (1.90-2.62), LVEF 49% (46-55), and creatinine clearance 108 (93-120) mL/kg per min. The median period of time since the patients had their latest angiography was 15 months (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). For the patients with a previous myocardial infarction CFR measurements were performed a median of 18 months (5-38) after the myocardial infarction.…”

A comparison of echocardiographic variables of right ventricular function with exercise capacity after bosentan treatment in patients with pulmonary arterial hypertension: Results from a multicenter, prospective, cohort study

“…the workup of patients with PAH. [14][15][16] This is particularly true because measurements of single-chamber parameters, such as LVEF or RVEF, usually correlate poorly with exercise capacity.…”