Article

Previous investigations have reported a relationship between variables
obtained from echocardiography with tissue Doppler imaging (TDI) and
cardiopulmonary exercise testing (CPX) in systolic heart failure (HF) cohorts.
The purpose of the present investigation was to perform a comparative analysis
between echocardiography with TDI and CPX in patients with HF and normal ejection
fraction (NEF). METHODS: Patients with HF-NEF (N = 32) underwent echocardiography
with TDI and CPX to determine the following variables: (1) the ratio between
mitral early velocity (E) and mitral annular velocity (E'), (2) ejection
fraction, (3) left ventricular (LV) mass, (4) left ventricular end systolic
volume, (5) peak oxygen uptake (.VO2), (6) ventilatory efficiency, (7) the
partial pressure of end-tidal carbon dioxide (P(ET)CO2) at rest and peak
exercise, and (8) heart rate recovery at 1 minute (HRR1). RESULTS: Pearson
correlation revealed that E/E' was significantly correlated with peak oxygen
uptake (r = -0.55, P = .001), the ventilatory efficiency slope (r = 0.60, P <
.001), resting P(ET)CO2 (r = -0.39, P = .03), peak P(ET)CO2 (r = -0.50, P =
.004), and HRR1 (r = -0.63, P < .001). Left ventricular mass and left ventricular
end systolic volume were not correlated with any CPX variable. Ejection fraction
was correlated with HRR1 (r = -0.55, P = .001). An HRR1 threshold of less than 16
and/or 16 or more beats per minute (higher value positive) effectively identified
subjects with an E/E' > 10 (positive likelihood ratio: 13:2). DISCUSSION: E/E'
provides an accurate reflection of LV filling pressure and thus, insight into
diastolic function. The results of the present investigation indicate CPX
provides insight into cardiac dysfunction in patients with HF-NEF and thus, may
eventually prove to be a valuable and accepted clinical assessment.

Langue : ANGLAIS