Stress Echocardiography-Derived E/e’ Predicts Abnormal Exercise Hemodynamics in Heart Failure With Preserved Ejection Fraction
BackgroundThe correlation between echocardiographic parameters and hemodynamics data in patients with heart failure with preserved ejection fraction (HFpEF) is unclear. It is important to find a non-invasive echocardiographic parameter for predicting exercise pulmonary capillary wedge pressure (PCWP...
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Frontiers Media S.A.
2019-12-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fphys.2019.01470/full |
| _version_ | 1811205114219724800 |
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| author | Zheng-Wei Chen Zheng-Wei Chen Chen-Yu Huang Chen-Yu Huang Jen-Fang Cheng Jen-Fang Cheng Ssu-Yuan Chen Ssu-Yuan Chen Lian-Yu Lin Cho-Kai Wu Cho-Kai Wu |
| author_facet | Zheng-Wei Chen Zheng-Wei Chen Chen-Yu Huang Chen-Yu Huang Jen-Fang Cheng Jen-Fang Cheng Ssu-Yuan Chen Ssu-Yuan Chen Lian-Yu Lin Cho-Kai Wu Cho-Kai Wu |
| author_sort | Zheng-Wei Chen |
| collection | DOAJ |
| description | BackgroundThe correlation between echocardiographic parameters and hemodynamics data in patients with heart failure with preserved ejection fraction (HFpEF) is unclear. It is important to find a non-invasive echocardiographic parameter for predicting exercise pulmonary capillary wedge pressure (PCWP).AimThis study sought to determine the correlation between echocardiographic parameters and hemodynamics data at rest and during exercise in HFpEF patients.Methods and ResultsThis study was a cross-sectional cohort exploratory analysis of baseline data from the ILO-HOPE trial. A total of 34 HFpEF patients were enrolled. The average age was 70 ± 12 years, and most (74%) were women. The patients underwent invasive cardiac catheterization and expired gas analysis at rest and during exercise. Echocardiography including tissue Doppler imaging was performed, and global longitudinal strain and other novel diastolic function indexes were analyzed at rest and during exercise. At rest, no significant correlation was noted between resting PCWP and echocardiographic parameters. However, a significant correlation was observed between post-exercise PCWP and stress E/e′ (septal, lateral, and mean) ratio (p = 0.003, 0.031, 0.012). Moreover, post-exercise ΔPCWP showed a good correlation with stress E/e′ (septal, lateral, and mean; all p ≤ 0.001) and global longitudinal strain (GLS) during exercise (p = 0.03). After multivariate regression analysis with adjustment for possible confounding factors including age and sex, there was still a significant correlation between post-exercise ΔPCWP and E/e′ (r = 0.62, p < 0.001 for E/e′mean).ConclusionOnly stress echocardiography derived tissue Doppler E/e′ ratio is closely correlated with abnormal exercise hemodynamics (PCWP and post-exercise ΔPCWP) in HFpEF. This echocardiographic marker is substantially more sensitive than other novel echocardiographic parameters during exercise, and may have significant diagnostic utility for ambulatory HFpEF patients with dyspnea.Clinical Trial Registrationhttps://www.clinicaltrials.gov, identifier NCT03620526. |
| first_indexed | 2024-04-12T03:25:04Z |
| format | Article |
| id | doaj.art-5e8f4817f820422e951029da1753f58c |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-04-12T03:25:04Z |
| publishDate | 2019-12-01 |
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| series | Frontiers in Physiology |
| spelling | doaj.art-5e8f4817f820422e951029da1753f58c2022-12-22T03:49:45ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2019-12-011010.3389/fphys.2019.01470468053Stress Echocardiography-Derived E/e’ Predicts Abnormal Exercise Hemodynamics in Heart Failure With Preserved Ejection FractionZheng-Wei Chen0Zheng-Wei Chen1Chen-Yu Huang2Chen-Yu Huang3Jen-Fang Cheng4Jen-Fang Cheng5Ssu-Yuan Chen6Ssu-Yuan Chen7Lian-Yu Lin8Cho-Kai Wu9Cho-Kai Wu10Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Yun-Lin Branch, Yun-Lin, TaiwanDivision of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine, Kinmen Hospital, Ministry of Health and Welfare, Kinmen, TaiwanDivision of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine, Pingtung Hospital, Pingtung, TaiwanDepartment of Physical Medicine and Rehabilitation, Fu Jen Catholic University Hospital and Fu Jen Catholic University School of Medicine, New Taipei City, TaiwanDepartment of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, TaiwanCardiovascular Institute, Stanford University, Stanford, CA, United StatesBackgroundThe correlation between echocardiographic parameters and hemodynamics data in patients with heart failure with preserved ejection fraction (HFpEF) is unclear. It is important to find a non-invasive echocardiographic parameter for predicting exercise pulmonary capillary wedge pressure (PCWP).AimThis study sought to determine the correlation between echocardiographic parameters and hemodynamics data at rest and during exercise in HFpEF patients.Methods and ResultsThis study was a cross-sectional cohort exploratory analysis of baseline data from the ILO-HOPE trial. A total of 34 HFpEF patients were enrolled. The average age was 70 ± 12 years, and most (74%) were women. The patients underwent invasive cardiac catheterization and expired gas analysis at rest and during exercise. Echocardiography including tissue Doppler imaging was performed, and global longitudinal strain and other novel diastolic function indexes were analyzed at rest and during exercise. At rest, no significant correlation was noted between resting PCWP and echocardiographic parameters. However, a significant correlation was observed between post-exercise PCWP and stress E/e′ (septal, lateral, and mean) ratio (p = 0.003, 0.031, 0.012). Moreover, post-exercise ΔPCWP showed a good correlation with stress E/e′ (septal, lateral, and mean; all p ≤ 0.001) and global longitudinal strain (GLS) during exercise (p = 0.03). After multivariate regression analysis with adjustment for possible confounding factors including age and sex, there was still a significant correlation between post-exercise ΔPCWP and E/e′ (r = 0.62, p < 0.001 for E/e′mean).ConclusionOnly stress echocardiography derived tissue Doppler E/e′ ratio is closely correlated with abnormal exercise hemodynamics (PCWP and post-exercise ΔPCWP) in HFpEF. This echocardiographic marker is substantially more sensitive than other novel echocardiographic parameters during exercise, and may have significant diagnostic utility for ambulatory HFpEF patients with dyspnea.Clinical Trial Registrationhttps://www.clinicaltrials.gov, identifier NCT03620526.https://www.frontiersin.org/article/10.3389/fphys.2019.01470/fullHFpEFstress Doppler echocardiographyhemodynamicsGLStissue Doppler and strain echocardiography |
| spellingShingle | Zheng-Wei Chen Zheng-Wei Chen Chen-Yu Huang Chen-Yu Huang Jen-Fang Cheng Jen-Fang Cheng Ssu-Yuan Chen Ssu-Yuan Chen Lian-Yu Lin Cho-Kai Wu Cho-Kai Wu Stress Echocardiography-Derived E/e’ Predicts Abnormal Exercise Hemodynamics in Heart Failure With Preserved Ejection Fraction Frontiers in Physiology HFpEF stress Doppler echocardiography hemodynamics GLS tissue Doppler and strain echocardiography |
| title | Stress Echocardiography-Derived E/e’ Predicts Abnormal Exercise Hemodynamics in Heart Failure With Preserved Ejection Fraction |
| title_full | Stress Echocardiography-Derived E/e’ Predicts Abnormal Exercise Hemodynamics in Heart Failure With Preserved Ejection Fraction |
| title_fullStr | Stress Echocardiography-Derived E/e’ Predicts Abnormal Exercise Hemodynamics in Heart Failure With Preserved Ejection Fraction |
| title_full_unstemmed | Stress Echocardiography-Derived E/e’ Predicts Abnormal Exercise Hemodynamics in Heart Failure With Preserved Ejection Fraction |
| title_short | Stress Echocardiography-Derived E/e’ Predicts Abnormal Exercise Hemodynamics in Heart Failure With Preserved Ejection Fraction |
| title_sort | stress echocardiography derived e e predicts abnormal exercise hemodynamics in heart failure with preserved ejection fraction |
| topic | HFpEF stress Doppler echocardiography hemodynamics GLS tissue Doppler and strain echocardiography |
| url | https://www.frontiersin.org/article/10.3389/fphys.2019.01470/full |
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