Left ventricular end-diastolic volume was the strongest independent echocardiographic predictor of peak VO2 (stdβ 0.30, p<0.001) and identified low cardiorespiratory fitness with an AUC of 0.72.
Cohort (n=2,876)
Yes
Does left ventricular end-diastolic volume predict low cardiorespiratory fitness and functional disability in individuals with normal ejection fraction?
Small resting left ventricular size is a strong independent echocardiographic predictor of low cardiorespiratory fitness and functional disability in individuals with normal ejection fraction.
Effect estimate: stdβ 0.30
p-value: p=<0.001
AIMS: Low cardiorespiratory fitness (CRF) is associated with functional disability, heart failure and mortality. Left ventricular (LV) end-diastolic volume (LVEDV) has been linked with CRF, but its utility as a diagnostic marker of low CRF has not been tested. METHODS: This multi-center international cohort examined the relationship between LV size on echocardiography and CRF (peak oxygen uptake peak VO2 from cardiopulmonary exercise testing) in individuals with LV ejection fraction ≥50%. Absolute and BSA-indexed LVEDV (LVEDVi) were tested as predictors of low CRF and functional disability (peak VO2 <1100ml/min or <18 ml/kg/min) and compared against candidate measures of cardiac structure and function. RESULTS: 2876 individuals (309 endurance athletes, 251 healthy non-athletes, 1969 individuals with unexplained dyspnea, 347 individuals with heart failure with preserved ejection fraction) were included. For the entire cohort, LVEDV had the strongest univariable association with peak VO2 (R2 =0.45, standardized stdβ 0.67, p<0.001) and remained the strongest independent predictor of peak VO2 after adjusting for age, sex and BMI (stdβ 0.30, p<0.001). LVEDV was better at identifying low CRF than most established echocardiographic measures (LVEDV AUC 0.72; LVEDVi AUC 0.71), but equivalent to the E/e' ratio. The probability of achieving a peak VO2 below the functional independence threshold was highest for smaller ventricular volumes, with LVEDV and LVEDVi of 88ml and 57ml/m2 providing the optimal cut-points, respectively. CONCLUSIONS: Small resting ventricular size is associated with a higher probability of low CRF and functional disability. LV size is the strongest independent echocardiographic predictor of CRF across the health-disease continuum.
Rowe et al. (Mon,) conducted a cohort in Normal ejection fraction (LVEF ≥50%) (n=2,876). Left ventricular end-diastolic volume (LVEDV) vs. Established echocardiographic measures was evaluated on Peak oxygen uptake (peak VO2) and low cardiorespiratory fitness (stdβ 0.30, p=<0.001). Left ventricular end-diastolic volume was the strongest independent echocardiographic predictor of peak VO2 (stdβ 0.30, p<0.001) and identified low cardiorespiratory fitness with an AUC of 0.72.