Dynamic change in left ventricular apical back rotation: A marker of diastolic suction with exercise

Sung Jin Hong, Chi Young Shim, Darae Kim, In Jeong Cho, Geu Ru Hong, Sun Ha Moon, Hyun Jin Lee, Jin Kyung Lee, Donghoon Choi, Yangsoo Jang, Jong Won Ha

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Aims We hypothesized that the absence of a decrease in minimal left ventricular (LV) pressure during exercise would be associated with impaired LV apical back rotation during exercise. Methods and results A total of 21 patients (59 ± 10 years) underwent invasive LV pressure measurements and simultaneous echocardiography at rest and during submaximal supine bicycle exercise. Patients were classified according to the changes in minimal LV pressure from rest to maximal exercise ("minimal LVP); Group 1 (n = 8) had a decrease in minimal LV pressure with exercise, whereas Group 2 (n = 13) had an increase in minimal LV pressure. LV apical back-rotation parameters by speckle-tracking echocardiography at rest and during 50 W of exercise were compared. At rest, there were no differences in LV pressure and echocardiographic parameters between groups. However, at 50 W of exercise, Group 2 had higher LV early and end-diastolic pressures and a prolonged time constant of LV relaxation. In Group 2, e' velocity was lower and E/e' was higher. Apical back rotation at the mitral valve opening (MVO) was reduced and minimal apical back-rotation velocity was lower in Group 2. "minimal LVP significantly correlated with apical back rotation at MVO (r = '0.77, P = 0.009) and minimal apical back-rotation velocity at 50 W (r = 0.69, P = 0.028). Conclusion The lack of decrease in minimal LV pressure during exercise, a manifestation of impaired LV suction in early diastole, is linked closely with impaired LV apical back rotation during exercise. Dynamic changes in LV apical back rotation during exercise can be used as a non-invasive parameter of diastolic suction during exercise. Published on behalf of the European Society of Cardiology. All rights reserved.

Original languageEnglish
Pages (from-to)12-19
Number of pages8
JournalEuropean heart journal cardiovascular Imaging
Volume19
Issue number1
DOIs
Publication statusPublished - 2018 Jan 1

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Suction
Exercise
Ventricular Pressure
Mitral Valve
Echocardiography
Diastole
Blood Pressure

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Hong, Sung Jin ; Shim, Chi Young ; Kim, Darae ; Cho, In Jeong ; Hong, Geu Ru ; Moon, Sun Ha ; Lee, Hyun Jin ; Lee, Jin Kyung ; Choi, Donghoon ; Jang, Yangsoo ; Ha, Jong Won. / Dynamic change in left ventricular apical back rotation : A marker of diastolic suction with exercise. In: European heart journal cardiovascular Imaging. 2018 ; Vol. 19, No. 1. pp. 12-19.
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title = "Dynamic change in left ventricular apical back rotation: A marker of diastolic suction with exercise",
abstract = "Aims We hypothesized that the absence of a decrease in minimal left ventricular (LV) pressure during exercise would be associated with impaired LV apical back rotation during exercise. Methods and results A total of 21 patients (59 ± 10 years) underwent invasive LV pressure measurements and simultaneous echocardiography at rest and during submaximal supine bicycle exercise. Patients were classified according to the changes in minimal LV pressure from rest to maximal exercise ({"}minimal LVP); Group 1 (n = 8) had a decrease in minimal LV pressure with exercise, whereas Group 2 (n = 13) had an increase in minimal LV pressure. LV apical back-rotation parameters by speckle-tracking echocardiography at rest and during 50 W of exercise were compared. At rest, there were no differences in LV pressure and echocardiographic parameters between groups. However, at 50 W of exercise, Group 2 had higher LV early and end-diastolic pressures and a prolonged time constant of LV relaxation. In Group 2, e' velocity was lower and E/e' was higher. Apical back rotation at the mitral valve opening (MVO) was reduced and minimal apical back-rotation velocity was lower in Group 2. {"}minimal LVP significantly correlated with apical back rotation at MVO (r = '0.77, P = 0.009) and minimal apical back-rotation velocity at 50 W (r = 0.69, P = 0.028). Conclusion The lack of decrease in minimal LV pressure during exercise, a manifestation of impaired LV suction in early diastole, is linked closely with impaired LV apical back rotation during exercise. Dynamic changes in LV apical back rotation during exercise can be used as a non-invasive parameter of diastolic suction during exercise. Published on behalf of the European Society of Cardiology. All rights reserved.",
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Dynamic change in left ventricular apical back rotation : A marker of diastolic suction with exercise. / Hong, Sung Jin; Shim, Chi Young; Kim, Darae; Cho, In Jeong; Hong, Geu Ru; Moon, Sun Ha; Lee, Hyun Jin; Lee, Jin Kyung; Choi, Donghoon; Jang, Yangsoo; Ha, Jong Won.

In: European heart journal cardiovascular Imaging, Vol. 19, No. 1, 01.01.2018, p. 12-19.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Dynamic change in left ventricular apical back rotation

T2 - A marker of diastolic suction with exercise

AU - Hong, Sung Jin

AU - Shim, Chi Young

AU - Kim, Darae

AU - Cho, In Jeong

AU - Hong, Geu Ru

AU - Moon, Sun Ha

AU - Lee, Hyun Jin

AU - Lee, Jin Kyung

AU - Choi, Donghoon

AU - Jang, Yangsoo

AU - Ha, Jong Won

PY - 2018/1/1

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N2 - Aims We hypothesized that the absence of a decrease in minimal left ventricular (LV) pressure during exercise would be associated with impaired LV apical back rotation during exercise. Methods and results A total of 21 patients (59 ± 10 years) underwent invasive LV pressure measurements and simultaneous echocardiography at rest and during submaximal supine bicycle exercise. Patients were classified according to the changes in minimal LV pressure from rest to maximal exercise ("minimal LVP); Group 1 (n = 8) had a decrease in minimal LV pressure with exercise, whereas Group 2 (n = 13) had an increase in minimal LV pressure. LV apical back-rotation parameters by speckle-tracking echocardiography at rest and during 50 W of exercise were compared. At rest, there were no differences in LV pressure and echocardiographic parameters between groups. However, at 50 W of exercise, Group 2 had higher LV early and end-diastolic pressures and a prolonged time constant of LV relaxation. In Group 2, e' velocity was lower and E/e' was higher. Apical back rotation at the mitral valve opening (MVO) was reduced and minimal apical back-rotation velocity was lower in Group 2. "minimal LVP significantly correlated with apical back rotation at MVO (r = '0.77, P = 0.009) and minimal apical back-rotation velocity at 50 W (r = 0.69, P = 0.028). Conclusion The lack of decrease in minimal LV pressure during exercise, a manifestation of impaired LV suction in early diastole, is linked closely with impaired LV apical back rotation during exercise. Dynamic changes in LV apical back rotation during exercise can be used as a non-invasive parameter of diastolic suction during exercise. Published on behalf of the European Society of Cardiology. All rights reserved.

AB - Aims We hypothesized that the absence of a decrease in minimal left ventricular (LV) pressure during exercise would be associated with impaired LV apical back rotation during exercise. Methods and results A total of 21 patients (59 ± 10 years) underwent invasive LV pressure measurements and simultaneous echocardiography at rest and during submaximal supine bicycle exercise. Patients were classified according to the changes in minimal LV pressure from rest to maximal exercise ("minimal LVP); Group 1 (n = 8) had a decrease in minimal LV pressure with exercise, whereas Group 2 (n = 13) had an increase in minimal LV pressure. LV apical back-rotation parameters by speckle-tracking echocardiography at rest and during 50 W of exercise were compared. At rest, there were no differences in LV pressure and echocardiographic parameters between groups. However, at 50 W of exercise, Group 2 had higher LV early and end-diastolic pressures and a prolonged time constant of LV relaxation. In Group 2, e' velocity was lower and E/e' was higher. Apical back rotation at the mitral valve opening (MVO) was reduced and minimal apical back-rotation velocity was lower in Group 2. "minimal LVP significantly correlated with apical back rotation at MVO (r = '0.77, P = 0.009) and minimal apical back-rotation velocity at 50 W (r = 0.69, P = 0.028). Conclusion The lack of decrease in minimal LV pressure during exercise, a manifestation of impaired LV suction in early diastole, is linked closely with impaired LV apical back rotation during exercise. Dynamic changes in LV apical back rotation during exercise can be used as a non-invasive parameter of diastolic suction during exercise. Published on behalf of the European Society of Cardiology. All rights reserved.

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