Incremental Value of Left Ventricular Diastolic Function Reserve Index for Predicting Exercise Capacity in Patients with Hypertrophic Cardiomyopathy

Eui Young Choi; Jong Won Ha; Se Joong Rim; Sung Ai Kim; Se Jung Yoon; Chi Young Shim; Jin Mi Kim; Yangsoo Jang; Namsik Chung; Seung Yun Cho

doi:10.1016/j.echo.2007.08.041

Incremental Value of Left Ventricular Diastolic Function Reserve Index for Predicting Exercise Capacity in Patients with Hypertrophic Cardiomyopathy

Eui Young Choi, Jong Won Ha, Se Joong Rim, Sung Ai Kim, Se Jung Yoon, Chi Young Shim, Jin Mi Kim, Yangsoo Jang, Namsik Chung, Seung Yun Cho

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

24 Citations (Scopus)

Abstract

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.

Original language	English
Pages (from-to)	487-492
Number of pages	6
Journal	Journal of the American Society of Echocardiography
Volume	21
Issue number	5
DOIs	https://doi.org/10.1016/j.echo.2007.08.041
Publication status	Published - 2008 May

Bibliographical note

Funding Information:
This work was supported by the Korea Science and Engineering Foundation (KOSEF) grant funded by the Korea government (M10642120001-06N4212-00110).

All Science Journal Classification (ASJC) codes

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

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10.1016/j.echo.2007.08.041

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Choi, E. Y., Ha, J. W., Rim, S. J., Kim, S. A., Yoon, S. J., Shim, C. Y., Kim, J. M., Jang, Y., Chung, N., & Cho, S. Y. (2008). Incremental Value of Left Ventricular Diastolic Function Reserve Index for Predicting Exercise Capacity in Patients with Hypertrophic Cardiomyopathy. Journal of the American Society of Echocardiography, 21(5), 487-492. https://doi.org/10.1016/j.echo.2007.08.041

@article{643d359ab47d44f4a229308e62e43baa,

title = "Incremental Value of Left Ventricular Diastolic Function Reserve Index for Predicting Exercise Capacity in Patients with Hypertrophic Cardiomyopathy",

abstract = "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.",

author = "Choi, {Eui Young} and Ha, {Jong Won} and Rim, {Se Joong} and Kim, {Sung Ai} and Yoon, {Se Jung} and Shim, {Chi Young} and Kim, {Jin Mi} and Yangsoo Jang and Namsik Chung and Cho, {Seung Yun}",

note = "Funding Information: This work was supported by the Korea Science and Engineering Foundation (KOSEF) grant funded by the Korea government (M10642120001-06N4212-00110). ",

year = "2008",

month = may,

doi = "10.1016/j.echo.2007.08.041",

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Choi, EY, Ha, JW, Rim, SJ, Kim, SA, Yoon, SJ, Shim, CY, Kim, JM, Jang, Y, Chung, N & Cho, SY 2008, 'Incremental Value of Left Ventricular Diastolic Function Reserve Index for Predicting Exercise Capacity in Patients with Hypertrophic Cardiomyopathy', Journal of the American Society of Echocardiography, vol. 21, no. 5, pp. 487-492. https://doi.org/10.1016/j.echo.2007.08.041

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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

N1 - Funding Information: This work was supported by the Korea Science and Engineering Foundation (KOSEF) grant funded by the Korea government (M10642120001-06N4212-00110).

PY - 2008/5

Y1 - 2008/5

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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Incremental Value of Left Ventricular Diastolic Function Reserve Index for Predicting Exercise Capacity in Patients with Hypertrophic Cardiomyopathy

Abstract

Bibliographical note

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