Exercise echocardiography identified isolated exercise-induced HFNEF in 20% of patients with HFNEF, with mitral annular systolic velocity serving as an independent predictor of the diagnosis.
Cross-Sectional (n=98)
Does exercise echocardiography help diagnose heart failure with normal ejection fraction in patients with exertional dyspnoea?
Exercise echocardiography, particularly the measurement of peak mitral annular systolic velocity (Sa), identifies a significant proportion of patients with heart failure with normal ejection fraction who only exhibit abnormalities during exercise.
AIMS: Few data are available on the exercise-induced abnormalities of myocardial function in patients with exertional dyspnoea and normal left ventricular ejection fraction (LV EF). The main aims of this study were to determine the prevalence of isolated exercise-induced heart failure with normal ejection fraction (HFNEF) and to assess whether disturbances in LV or right ventricular longitudinal systolic function are associated with the diagnosis of HFNEF. METHODS AND RESULTS: Eighty-four patients with exertional dyspnoea and normal LV EF and 14 healthy controls underwent spirometry, NT-proBNP plasma analysis, and exercise echocardiography. Doppler LV inflow and tissue mitral and tricuspid annular velocities were analysed at rest and immediately after the termination of exercise. Of the 30 patients with the evidence of HFNEF, 6 (20%) patients had only isolated exercise-induced HFNEF. When compared with the remaining patients, those with HFNEF had a significantly lower resting and exercise peak mitral annular systolic velocity (Sa) and the mitral annular velocity during atrial contraction, lower exercise peak mitral annular velocity at early diastole, and lower exercise peak systolic velocity of tricuspid annular motion. The multivariate logistic regression analysis including both parameters standardly defining HFNEF and the new Doppler variables potentially associated with the diagnosis of HFNEF revealed that NT-proBNP, LV mass index, left atrial volume index, and Sa significantly and independently predict the diagnosis of HFNEF. CONCLUSION: A significant proportion of patients require exercise to diagnose HFNEF. Sa appears to be a significant independent predictor of HFNEF, which may increase the diagnostic value of models utilizing the variables recommended by the European Society of Cardiology guidelines.
Meluzı́n et al. (Fri,) conducted a cross-sectional in Exertional dyspnoea with normal left ventricular ejection fraction (n=98). Exercise echocardiography vs. Healthy controls / Patients without HFNEF was evaluated on Prevalence of isolated exercise-induced HFNEF and predictors of HFNEF. Exercise echocardiography identified isolated exercise-induced HFNEF in 20% of patients with HFNEF, with mitral annular systolic velocity serving as an independent predictor of the diagnosis.