TY - JOUR
T1 - Incremental Value of Left Ventricular Diastolic Function Reserve Index for Predicting Exercise Capacity in Patients with Hypertrophic Cardiomyopathy
AU - Choi, Eui Young
AU - Ha, Jong Won
AU - Rim, Se Joong
AU - Kim, Sung Ai
AU - Yoon, Se Jung
AU - Shim, Chi Young
AU - Kim, Jin Mi
AU - Jang, Yangsoo
AU - Chung, Namsik
AU - Cho, Seung Yun
PY - 2008/5/1
Y1 - 2008/5/1
N2 - The changes of left ventricular diastolic function during exercise are heterogeneous in patients with hypertrophic cardiomyopathy (HCM). We sought to investigate whether exertional changes of mitral annular velocities and plasma N-terminal-pro-B-type natriuretic peptide (BNP) concentration are associated with exercise capacity in patients with HCM. After a comprehensive echocardiographic study, 32 patients with HCM performed symptom-limited graded supine bicycle exercise. Echocardiographic Doppler parameters were measured at each stage of exercise. Blood samples were collected at rest and immediately after exercise to determine the concentration of pro-BNP. Resting pro-BNP (r = -0.620, P < .001), E'base (r = 0.414, P = .018), and ΔE'50W (change of E' from base to 50 W of exercise) (r = 0.367, P = .039) were significantly correlated with exercise duration. Left ventricular longitudinal diastolic function reserve index, defined as ΔE' × E'base, significantly correlated with exercise duration (at 50 W, r = 0.540, P = .001) independent of age, sex, body mass index, and resting pro-BNP level. When combining ΔE' × E'50W (<5.85 cm2/s2) and resting pro-BNP (>740 mg/dL), the predictive accuracy for exercise capacity could be improved (for <500 seconds, global χ2 = 5.84 in pro-BNP vs 8.10 in pro-BNP + ΔE' × E'50W, P = .023). The assessment of left ventricular longitudinal diastolic function reserve can provide incremental information to pro-BNP for the prediction of exercise capacity in patients with HCM.
AB - The changes of left ventricular diastolic function during exercise are heterogeneous in patients with hypertrophic cardiomyopathy (HCM). We sought to investigate whether exertional changes of mitral annular velocities and plasma N-terminal-pro-B-type natriuretic peptide (BNP) concentration are associated with exercise capacity in patients with HCM. After a comprehensive echocardiographic study, 32 patients with HCM performed symptom-limited graded supine bicycle exercise. Echocardiographic Doppler parameters were measured at each stage of exercise. Blood samples were collected at rest and immediately after exercise to determine the concentration of pro-BNP. Resting pro-BNP (r = -0.620, P < .001), E'base (r = 0.414, P = .018), and ΔE'50W (change of E' from base to 50 W of exercise) (r = 0.367, P = .039) were significantly correlated with exercise duration. Left ventricular longitudinal diastolic function reserve index, defined as ΔE' × E'base, significantly correlated with exercise duration (at 50 W, r = 0.540, P = .001) independent of age, sex, body mass index, and resting pro-BNP level. When combining ΔE' × E'50W (<5.85 cm2/s2) and resting pro-BNP (>740 mg/dL), the predictive accuracy for exercise capacity could be improved (for <500 seconds, global χ2 = 5.84 in pro-BNP vs 8.10 in pro-BNP + ΔE' × E'50W, P = .023). The assessment of left ventricular longitudinal diastolic function reserve can provide incremental information to pro-BNP for the prediction of exercise capacity in patients with HCM.
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U2 - 10.1016/j.echo.2007.08.041
DO - 10.1016/j.echo.2007.08.041
M3 - Article
C2 - 17904804
AN - SCOPUS:43049130290
VL - 21
SP - 487
EP - 492
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
SN - 0894-7317
IS - 5
ER -