Role of Diastolic Function in Preserved Exercise Capacity in Patients with Reduced Ejection Fractions

Takahiro Ohara, Hiroyuki Iwano, Vinay Thohan, Dalane W. Kitzman, Bharathi Upadhya, Min Pu, William C. Little

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background Some patients with markedly reduced ejection fractions (EFs) (<35%) have preserved exercise performance greater than predicted for age and gender. Because diastolic function may be a determinant of exercise performance, this study was conducted to test the hypothesis that patients with preserved exercise tolerance despite EFs < 35% may have relatively normal diastolic function. Methods Sixty-five subjects with EFs < 35% who underwent exercise Doppler echocardiography and had no inducible ischemia were retrospectively examined. Forty-five subjects with normal EFs (>60%) and preserved exercise capacity were analyzed as a control group. Results Sixteen of 65 patients with EFs < 35% had greater than predicted normal exercise capacity for their age and gender, and the remaining 49 patients had reduced exercise capacity. Patients with reduced EFs and preserved exercise capacity had E/e′ ratios (mean, 10 ± 4) similar to those of control subjects (mean, 10 ± 3) and lower than those with reduced exercise tolerance (mean, 16 ± 8) (P <.01). In addition, they had better diastolic filling patterns and smaller left atrial sizes than patients with EFs < 35% and reduced exercise capacity. Multivariate logistic regression analyses indicated that E/e′ ratio was an independent predictor of preserved exercise capacity in patients with reduced EFs. Conclusions Relatively intact diastolic function contributes to preserved exercise capacity in patients with reduced EFs (<35%).

Original languageEnglish (US)
Pages (from-to)1184-1193
Number of pages10
JournalJournal of the American Society of Echocardiography
Volume28
Issue number10
DOIs
StatePublished - Oct 2015
Externally publishedYes

Keywords

  • Diastole
  • Echocardiography
  • Exercise
  • Heart failure

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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