Peak exercise myocardial deformation indices during cardiopulmonary exercise testing are associated with exercise capacity and ventilatory efficiency in patients with dilated cardiomyopathy
Objective: Little is known about the exercise-induced changes in the multidimensional mechanical properties of the heart. We aimed to evaluate the myocardial deformation indices (MDI) at rest and their response at peak exercise during the same cardiopulmonary exercise testing (CPET) session, investi...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-03-01
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| Series: | Hellenic Journal of Cardiology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S110996662200183X |
| _version_ | 1797857680258236416 |
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| author | Helen Triantafyllidi Dionyssia Birmpa Ignatios Ikonomidis Dimitrios Benas George Makavos Dennis V. Cokkinos Filippos Triposkiadis Efstathios K. Iliodromitis |
| author_facet | Helen Triantafyllidi Dionyssia Birmpa Ignatios Ikonomidis Dimitrios Benas George Makavos Dennis V. Cokkinos Filippos Triposkiadis Efstathios K. Iliodromitis |
| author_sort | Helen Triantafyllidi |
| collection | DOAJ |
| description | Objective: Little is known about the exercise-induced changes in the multidimensional mechanical properties of the heart. We aimed to evaluate the myocardial deformation indices (MDI) at rest and their response at peak exercise during the same cardiopulmonary exercise testing (CPET) session, investigating their relationship to exercise capacity and ventilatory sufficiency in dilated cardiomyopathy (DCM) patients. Methods: We evaluated left ventricular (LV) function using speckle tracking imaging (STI) at rest and peak exercise during the same CPET session in 57 idiopathic DCM patients in New York Heart Association (NYHA) I–II class [54 ± 12 years, 42 males, ejection fraction (EF) 33 ± 9%]. We measured global longitudinal strain (GLS), longitudinal strain rate at systole (LSRS) and diastole (LSRD), and circumferential strain rate (CircS). Results: Resting GLS, LSRS, and LSRD were impaired compared with the predicted values but were improved at peak exercise (p < 0.001). All MDI at rest and/or at peak exercise were related to several CPET-derived parameters, including peak VO2, load, O2 pulse, and VE/VCO2 slope. Peak exercise LSRS > −1.10 sec−1 (AUC = 0.80, p < 0.001) and GLS > −13% (AUC = 0.81, p = 0.002) predicted impaired exercise capacity (peak VO2 < 20 ml/min/kg) and ventilatory inefficiency (VE/VCO2 slope>34). In multiple regression analysis, peak exercise LSRS and GLS were independently related to the peak VO2 (Beta = −0.39, p = 0.003) and VE/VCO2 slope (Beta = 0.35, p = 0.02), respectively. Conclusions: Peak exercise LSRS and GLS in NYHA I–II DCM patients subjected to CPET were associated with aerobic exercise capacity and ventilatory efficiency. Consequently, LSRS and GLS at peak exercise, through their association with CPET-derived CV risk indices, may underline the severity of heart failure and predict future CV events in this DCM population. |
| first_indexed | 2024-04-09T21:00:43Z |
| format | Article |
| id | doaj.art-51f1c48209df4938bf0b4499d18ebb53 |
| institution | Directory Open Access Journal |
| issn | 1109-9666 |
| language | English |
| last_indexed | 2024-04-09T21:00:43Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Hellenic Journal of Cardiology |
| spelling | doaj.art-51f1c48209df4938bf0b4499d18ebb532023-03-29T09:25:11ZengElsevierHellenic Journal of Cardiology1109-96662023-03-01702835Peak exercise myocardial deformation indices during cardiopulmonary exercise testing are associated with exercise capacity and ventilatory efficiency in patients with dilated cardiomyopathyHelen Triantafyllidi0Dionyssia Birmpa1Ignatios Ikonomidis2Dimitrios Benas3George Makavos4Dennis V. Cokkinos5Filippos Triposkiadis6Efstathios K. Iliodromitis72nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, ATTIKON Hospital, Athens, Greece; Corresponding author. 2nd Cardiology Department, Attikon Hospital, Medical School, University of Athens, 83, Agiou Ioannou Theologou, Holargos, 155 61, Athens, Greece. Tel: 011306944268623.2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, ATTIKON Hospital, Athens, Greece2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, ATTIKON Hospital, Athens, Greece2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, ATTIKON Hospital, Athens, Greece2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, ATTIKON Hospital, Athens, GreeceBiomedical Research Foundation, Academy of Athens, Athens, GreeceDepartment of Cardiology, Medical School, Larissa University, General Hospital, Larissa, Greece2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, ATTIKON Hospital, Athens, GreeceObjective: Little is known about the exercise-induced changes in the multidimensional mechanical properties of the heart. We aimed to evaluate the myocardial deformation indices (MDI) at rest and their response at peak exercise during the same cardiopulmonary exercise testing (CPET) session, investigating their relationship to exercise capacity and ventilatory sufficiency in dilated cardiomyopathy (DCM) patients. Methods: We evaluated left ventricular (LV) function using speckle tracking imaging (STI) at rest and peak exercise during the same CPET session in 57 idiopathic DCM patients in New York Heart Association (NYHA) I–II class [54 ± 12 years, 42 males, ejection fraction (EF) 33 ± 9%]. We measured global longitudinal strain (GLS), longitudinal strain rate at systole (LSRS) and diastole (LSRD), and circumferential strain rate (CircS). Results: Resting GLS, LSRS, and LSRD were impaired compared with the predicted values but were improved at peak exercise (p < 0.001). All MDI at rest and/or at peak exercise were related to several CPET-derived parameters, including peak VO2, load, O2 pulse, and VE/VCO2 slope. Peak exercise LSRS > −1.10 sec−1 (AUC = 0.80, p < 0.001) and GLS > −13% (AUC = 0.81, p = 0.002) predicted impaired exercise capacity (peak VO2 < 20 ml/min/kg) and ventilatory inefficiency (VE/VCO2 slope>34). In multiple regression analysis, peak exercise LSRS and GLS were independently related to the peak VO2 (Beta = −0.39, p = 0.003) and VE/VCO2 slope (Beta = 0.35, p = 0.02), respectively. Conclusions: Peak exercise LSRS and GLS in NYHA I–II DCM patients subjected to CPET were associated with aerobic exercise capacity and ventilatory efficiency. Consequently, LSRS and GLS at peak exercise, through their association with CPET-derived CV risk indices, may underline the severity of heart failure and predict future CV events in this DCM population.http://www.sciencedirect.com/science/article/pii/S110996662200183XDilated cardiomyopathy (DCM)cardiopulmonary exercise test (CPET)left ventricular myocardial deformation indicesglobal longitudinal strain (GLS)left ventricular strain rate at systole (LSRS) |
| spellingShingle | Helen Triantafyllidi Dionyssia Birmpa Ignatios Ikonomidis Dimitrios Benas George Makavos Dennis V. Cokkinos Filippos Triposkiadis Efstathios K. Iliodromitis Peak exercise myocardial deformation indices during cardiopulmonary exercise testing are associated with exercise capacity and ventilatory efficiency in patients with dilated cardiomyopathy Hellenic Journal of Cardiology Dilated cardiomyopathy (DCM) cardiopulmonary exercise test (CPET) left ventricular myocardial deformation indices global longitudinal strain (GLS) left ventricular strain rate at systole (LSRS) |
| title | Peak exercise myocardial deformation indices during cardiopulmonary exercise testing are associated with exercise capacity and ventilatory efficiency in patients with dilated cardiomyopathy |
| title_full | Peak exercise myocardial deformation indices during cardiopulmonary exercise testing are associated with exercise capacity and ventilatory efficiency in patients with dilated cardiomyopathy |
| title_fullStr | Peak exercise myocardial deformation indices during cardiopulmonary exercise testing are associated with exercise capacity and ventilatory efficiency in patients with dilated cardiomyopathy |
| title_full_unstemmed | Peak exercise myocardial deformation indices during cardiopulmonary exercise testing are associated with exercise capacity and ventilatory efficiency in patients with dilated cardiomyopathy |
| title_short | Peak exercise myocardial deformation indices during cardiopulmonary exercise testing are associated with exercise capacity and ventilatory efficiency in patients with dilated cardiomyopathy |
| title_sort | peak exercise myocardial deformation indices during cardiopulmonary exercise testing are associated with exercise capacity and ventilatory efficiency in patients with dilated cardiomyopathy |
| topic | Dilated cardiomyopathy (DCM) cardiopulmonary exercise test (CPET) left ventricular myocardial deformation indices global longitudinal strain (GLS) left ventricular strain rate at systole (LSRS) |
| url | http://www.sciencedirect.com/science/article/pii/S110996662200183X |
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