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 language | English (US) |
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Pages (from-to) | 1184-1193 |
Number of pages | 10 |
Journal | Journal of the American Society of Echocardiography |
Volume | 28 |
Issue number | 10 |
DOIs | |
State | Published - Oct 2015 |
Externally published | Yes |
Keywords
- Diastole
- Echocardiography
- Exercise
- Heart failure
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine