Reference : Left ventricular regional function and maximal exercise capacity in aortic stenosis.
Scientific journals : Article
Human health sciences : Cardiovascular & respiratory systems
http://hdl.handle.net/2268/183552
Left ventricular regional function and maximal exercise capacity in aortic stenosis.
English
DULGHERU, Raluca Elena [Centre Hospitalier Universitaire de Liège - CHU > > Cardiologie >]
Magne, Julien [CHU Limoges, Hôpital Dupuytren > > Cardiologie > >]
DAVIN, Laurent mailto [Centre Hospitalier Universitaire de Liège - CHU > > Cardiologie >]
NCHIMI LONGANG, Alain mailto [Centre Hospitalier Universitaire de Liège - CHU > > Service médical de radiodiagnostic >]
Oury, Cécile mailto [Université de Liège > Département des sciences biomédicales et précliniques > GIGA-R : Génétique humaine >]
Pierard, Luc mailto [Université de Liège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation >]
Lancellotti, Patrizio mailto [Université de Liège > Département des sciences cliniques > Imagerie cardiaque fonctionnelle par échographie >]
2016
European Heart Journal - Cardiovascular Imaging
Oxford University Press
Yes (verified by ORBi)
International
2047-2404
2047-2412
Oxford
United Kingdom
[en] aortic stenosis ; cardiopulmonary test ; functional capacity ; longitudinal strain
[en] AIMS: The objective assessment of maximal exercise capacity (MEC) using peak oxygen consumption (VO2) measurement may be helpful in the management of asymptomatic aortic stenosis (AS) patients. However, the relationship between left ventricular (LV) function and MEC has been relatively unexplored. We aimed to identify which echocardiographic parameters of LV systolic function can predict MEC in asymptomatic AS. METHODS AND RESULTS: Asymptomatic patients with moderate to severe AS (n = 44, aortic valve area <1.5 cm2, 66 +/- 13 years, 75% of men) and preserved LV ejection fraction (LVEF > 50%) were prospectively referred for resting echocardiography and cardiopulmonary exercise test. LV longitudinal strain (LS) of each myocardial segment was measured by speckle tracking echocardiography (STE) from the apical (aLS) 4-, 2-, and 3-chamber views. An average value of the LS of the analysable segments was provided for each myocardial region: basal (bLS), mid (mLS), and aLS. LV circumferential and radial strains were measured from short-axis views. Peak VO2 was 20.1 +/- 5.8 mL/kg/min (median 20.7 mL/kg/min; range 7.2-32.3 mL/kg/min). According to the median of peak VO2, patients with reduced MEC were significantly older (P < 0.001) and more frequently females (P = 0.05). There were significant correlations between peak VO2 and age (r = -0.44), LV end-diastolic volume (r = 0.35), LV stroke volume (r = 0.37), indexed stroke volume (r = 0.32), and E/e' ratio (r = -0.37, all P < 0.04). Parameters of AS severity and LVEF did not correlate with peak VO2 (P = NS for all). Among LV deformation parameters, bLS and mLS were significantly associated with peakVO2 (r = 0.43, P = 0.005, and r = 0.32, P = 0.04, respectively). With multivariable analysis, female gender (beta = 4.9; P = 0.008) and bLS (beta = 0.50; P = 0.03) were the only independent determinants (r2 = 0.423) of peak VO2. CONCLUSION: In asymptomatic AS, impaired LV myocardial longitudinal function determines reduced MEC. Basal LS was the only parameter of LV regional function independently associated with MEC.
http://hdl.handle.net/2268/183552
also: http://hdl.handle.net/2268/185249
10.1093/ehjci/jev147
Published on behalf of the European Society of Cardiology. All rights reserved. (c) The Author 2015. For permissions please email: journals.permissions@oup.com.

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