Left ventricular markers of global dyssynchrony predict limited exercise capacity in heart failure, but not in patients with preserved ejection fraction
<p>Abstract</p> <p>Background</p> <p>The aim of this study was to prospectively examine echocardiographic parameters that correlate and predict functional capacity assessed by 6 min walk test (6-MWT) in patients with heart failure (HF), irrespective of ejection fraction...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2012-09-01
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| Series: | Cardiovascular Ultrasound |
| Subjects: | |
| Online Access: | http://www.cardiovascularultrasound.com/content/10/1/36 |
| _version_ | 1818140461414481920 |
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| author | Bajraktari Gani Batalli Arlind Poniku Afrim Ahmeti Artan Olloni Rozafa Hyseni Violeta Vela Zana Morina Besim Tafarshiku Rina Vela Driton Rashiti Premtim Haliti Edmond Henein Michael Y |
| author_facet | Bajraktari Gani Batalli Arlind Poniku Afrim Ahmeti Artan Olloni Rozafa Hyseni Violeta Vela Zana Morina Besim Tafarshiku Rina Vela Driton Rashiti Premtim Haliti Edmond Henein Michael Y |
| author_sort | Bajraktari Gani |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>The aim of this study was to prospectively examine echocardiographic parameters that correlate and predict functional capacity assessed by 6 min walk test (6-MWT) in patients with heart failure (HF), irrespective of ejection fraction (EF).</p> <p>Methods</p> <p>In 147 HF patients (mean age 61 ± 11 years, 50.3% male), a 6-MWT and an echo-Doppler study were performed in the same day. Global LV dyssynchrony was indirectly assessed by total isovolumic time - t-IVT [in s/min; calculated as: 60 – (total ejection time + total filling time)], and Tei index (t-IVT/ejection time). Patients were divided into two groups based on the 6-MWT distance (Group I: ≤300 m and Group II: >300 m), and also in two groups according to EF (Group A: LVEF ≥ 45% and Group B: LVEF < 45%).</p> <p>Results</p> <p>In the cohort of patients as a whole, the 6-MWT correlated with t-IVT (r = −0.49, p < 0.001) and Tei index (r = −0.43, p < 0.001) but not with any of the other clinical or echocardiographic parameters. Group I had lower hemoglobin level (p = 0.02), lower EF (p = 0.003), larger left atrium (p = 0.02), thicker interventricular septum (p = 0.02), lower A wave (p = 0.01) and lateral wall late diastolic myocardial velocity a’ (p = 0.047), longer isovolumic relaxation time (r = 0.003) and longer t-IVT (p = 0.03), compared with Group II. In the patients cohort as a whole, only t-IVT ratio [1.257 (1.071-1.476), p = 0.005], LV EF [0.947 (0.903-0.993), p = 0.02], and E/A ratio [0.553 (0.315-0.972), p = 0.04] independently predicted poor 6-MWT performance (<300 m) in multivariate analysis. None of the echocardiographic measurements predicted exercise tolerance in HFpEF.</p> <p>Conclusion</p> <p>In patients with HF, the limited exercise capacity, assessed by 6-MWT, is related mostly to severity of global LV dyssynchrony, more than EF or raised filling pressures. The lack of exercise predictors in HFpEF reflects its multifactorial pathophysiology.</p> |
| first_indexed | 2024-12-11T10:44:21Z |
| format | Article |
| id | doaj.art-f18827523bea47c8977687eca9d49e32 |
| institution | Directory Open Access Journal |
| issn | 1476-7120 |
| language | English |
| last_indexed | 2024-12-11T10:44:21Z |
| publishDate | 2012-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Ultrasound |
| spelling | doaj.art-f18827523bea47c8977687eca9d49e322022-12-22T01:10:31ZengBMCCardiovascular Ultrasound1476-71202012-09-011013610.1186/1476-7120-10-36Left ventricular markers of global dyssynchrony predict limited exercise capacity in heart failure, but not in patients with preserved ejection fractionBajraktari GaniBatalli ArlindPoniku AfrimAhmeti ArtanOlloni RozafaHyseni VioletaVela ZanaMorina BesimTafarshiku RinaVela DritonRashiti PremtimHaliti EdmondHenein Michael Y<p>Abstract</p> <p>Background</p> <p>The aim of this study was to prospectively examine echocardiographic parameters that correlate and predict functional capacity assessed by 6 min walk test (6-MWT) in patients with heart failure (HF), irrespective of ejection fraction (EF).</p> <p>Methods</p> <p>In 147 HF patients (mean age 61 ± 11 years, 50.3% male), a 6-MWT and an echo-Doppler study were performed in the same day. Global LV dyssynchrony was indirectly assessed by total isovolumic time - t-IVT [in s/min; calculated as: 60 – (total ejection time + total filling time)], and Tei index (t-IVT/ejection time). Patients were divided into two groups based on the 6-MWT distance (Group I: ≤300 m and Group II: >300 m), and also in two groups according to EF (Group A: LVEF ≥ 45% and Group B: LVEF < 45%).</p> <p>Results</p> <p>In the cohort of patients as a whole, the 6-MWT correlated with t-IVT (r = −0.49, p < 0.001) and Tei index (r = −0.43, p < 0.001) but not with any of the other clinical or echocardiographic parameters. Group I had lower hemoglobin level (p = 0.02), lower EF (p = 0.003), larger left atrium (p = 0.02), thicker interventricular septum (p = 0.02), lower A wave (p = 0.01) and lateral wall late diastolic myocardial velocity a’ (p = 0.047), longer isovolumic relaxation time (r = 0.003) and longer t-IVT (p = 0.03), compared with Group II. In the patients cohort as a whole, only t-IVT ratio [1.257 (1.071-1.476), p = 0.005], LV EF [0.947 (0.903-0.993), p = 0.02], and E/A ratio [0.553 (0.315-0.972), p = 0.04] independently predicted poor 6-MWT performance (<300 m) in multivariate analysis. None of the echocardiographic measurements predicted exercise tolerance in HFpEF.</p> <p>Conclusion</p> <p>In patients with HF, the limited exercise capacity, assessed by 6-MWT, is related mostly to severity of global LV dyssynchrony, more than EF or raised filling pressures. The lack of exercise predictors in HFpEF reflects its multifactorial pathophysiology.</p>http://www.cardiovascularultrasound.com/content/10/1/36Six-minute walk testDoppler echocardiographyLV function and dyssynchrony |
| spellingShingle | Bajraktari Gani Batalli Arlind Poniku Afrim Ahmeti Artan Olloni Rozafa Hyseni Violeta Vela Zana Morina Besim Tafarshiku Rina Vela Driton Rashiti Premtim Haliti Edmond Henein Michael Y Left ventricular markers of global dyssynchrony predict limited exercise capacity in heart failure, but not in patients with preserved ejection fraction Cardiovascular Ultrasound Six-minute walk test Doppler echocardiography LV function and dyssynchrony |
| title | Left ventricular markers of global dyssynchrony predict limited exercise capacity in heart failure, but not in patients with preserved ejection fraction |
| title_full | Left ventricular markers of global dyssynchrony predict limited exercise capacity in heart failure, but not in patients with preserved ejection fraction |
| title_fullStr | Left ventricular markers of global dyssynchrony predict limited exercise capacity in heart failure, but not in patients with preserved ejection fraction |
| title_full_unstemmed | Left ventricular markers of global dyssynchrony predict limited exercise capacity in heart failure, but not in patients with preserved ejection fraction |
| title_short | Left ventricular markers of global dyssynchrony predict limited exercise capacity in heart failure, but not in patients with preserved ejection fraction |
| title_sort | left ventricular markers of global dyssynchrony predict limited exercise capacity in heart failure but not in patients with preserved ejection fraction |
| topic | Six-minute walk test Doppler echocardiography LV function and dyssynchrony |
| url | http://www.cardiovascularultrasound.com/content/10/1/36 |
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