June 4, 2005AJP Heart and Circulatory Physiology
Relationship of diastolic intraventricular pressure gradients and aerobic capacity in patients with diastolic heart failure
Why the study?
Does the change in diastolic intraventricular pressure gradients (IVPG) during exercise correlate with aerobic capacity in patients with heart failure?
Population
31 patients with heart failure and 15 normal subjects
Comparison
Metabolic treadmill stress testing with… vs Normal subjects
Design
Cross-sectional
Authors
Discussion
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Implication
Reduced exercise-induced IVPG augmentation was associated with lower VO2max in HF; hypothesis-generating for diastolic suction as a therapeutic target.
Key Points
- To evaluate the relationship between diastolic intraventricular pressure gradients and exercise tolerance in patients with heart failure using color M-mode Doppler echocardiography.
- Recruited 31 patients with heart failure and 15 healthy control subjects.
- Performed echocardiography before and immediately after metabolic treadmill stress testing.
- Assessed diastolic propagation velocity (Vp) and calculated intraventricular pressure gradients (IVPG) off-line using color M-mode Doppler.
- Resting myocardial relaxation velocity (r = 0.8), Vp (r = 0.5), and E/Vp (r = -0.5) significantly correlated with VO2max (P < 0.001 for all).
- Exercise increased IVPG significantly less in heart failure patients compared to normal subjects (1.1 ± 0.8 vs. 2.6 ± 0.8 mmHg, P < 0.05).
- The exercise-induced increase in IVPG strongly correlated with peak VO2max (r = 0.8, P < 0.001) and was the strongest predictor of exercise capacity.
Structured PICO
Does the change in diastolic intraventricular pressure gradients (IVPG) during exercise correlate with aerobic capacity in patients with heart failure?
P
Population
31 patients with heart failure and 15 normal subjects
I
Intervention
Metabolic treadmill stress testing with echocardiograms (color M-mode Doppler)
C
Comparator
Normal subjects
O
Outcome
Relationship between diastolic intraventricular pressure gradients (IVPG) and aerobic capacity (VO2max)surrogate
Impaired myocardial relaxation in heart failure patients is associated with reduced diastolic suction force during exercise, which correlates strongly with reduced aerobic capacity.
Cite This Study
Rovner et al. (2005) studied this question.