Early diastolic function during exertion influences exercise intolerance in patients with hypertrophic cardiomyopathy View Full Text


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Article Info

DATE

2012-10-19

AUTHORS

Kei Mizukoshi, Kengo Suzuki, Kihei Yoneyama, Ryo Kamijima, Seisyou Kou, Manabu Takai, Masaki Izumo, Akio Hayashi, Eiji Ohtaki, Yoshihiro J. Akashi, Naohiko Osada, Kazuto Omiya, Tomoo Harada, Sachihiko Nobuoka, Fumihiko Miyake

ABSTRACT

BackgroundHypertrophic cardiomyopathy (HCM) patients with preserved left ventricular ejection fraction (LVEF) often develop dyspnea and exercise intolerance. Diastolic dysfunction may contribute to exercise intolerance in these patients. This study aimed to clarify our hypothesis as to whether diastolic function rather than systolic function would be associated with exercise intolerance in HCM using two-dimensional (2D) speckle tracking echocardiography during exercise.MethodsThirty-three HCM patients (mean age 59.3 ± 15.7 years) underwent 2D speckle tracking echocardiography at rest and during submaximal semi-supine bicycle exercise. Global longitudinal strain (LS), LS rate during systole (LSRs), early diastole (LSRe), and late diastole (LSRa) were measured. The symptom-limited cardiopulmonary exercise testing was performed using a cycle ergometer for measuring the peak oxygen consumption (peak \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}_{{{\text{O}}_{2} }} $$\end{document}).ResultsIn the multivariate linear regression analysis, peak \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}_{{{\text{O}}_{2} }} $$\end{document} did not associate with strain or strain rate at rest. However, peak \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}_{{{\text{O}}_{2} }} $$\end{document} correlated with LS (β = −0.403, p = 0.007), LSRe (β = 6.041, p = 0.001), and LSRa (β = 5.117, p = 0.021) during exercise after adjustment for age, gender, and heart rate. The first quartile peak \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}_{{{\text{O}}_{2} }} $$\end{document} (14.2 mL/min/kg) was assessed to predict exercise intolerance. The C-statistic of delta LSRe was 0.74, which was relatively greater than that of delta LS (0.70) and delta LSRa (0.58), indicating that early diastolic function rather than systolic and late diastolic function affects exercise intolerance.ConclusionsLSRe during exercise is closely associated with the peak \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}_{{{\text{O}}_{2} }} $$\end{document}. Early diastolic function during exercise is an important determinant of exercise capacity in patients with HCM. More... »

PAGES

9-17

References to SciGraph publications

  • 2008. The Sarcomere and the Nucleus: Functional Links to Hypertrophy, Atrophy and Sarcopenia in THE SARCOMERE AND SKELETAL MUSCLE DISEASE
  • 2006-09. Modification of myocardial substrate use as a therapy for heart failure in NATURE CLINICAL PRACTICE CARDIOVASCULAR MEDICINE
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    http://scigraph.springernature.com/pub.10.1007/s12574-012-0150-0

    DOI

    http://dx.doi.org/10.1007/s12574-012-0150-0

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1033212377

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/27278427


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        "description": "BackgroundHypertrophic cardiomyopathy (HCM) patients with preserved left ventricular ejection fraction (LVEF) often develop dyspnea and exercise intolerance. Diastolic dysfunction may contribute to exercise intolerance in these patients. This study aimed to clarify our hypothesis as to whether diastolic function rather than systolic function would be associated with exercise intolerance in HCM using two-dimensional (2D) speckle tracking echocardiography during exercise.MethodsThirty-three HCM patients (mean age 59.3\u00a0\u00b1\u00a015.7\u00a0years) underwent 2D speckle tracking echocardiography at rest and during submaximal semi-supine bicycle exercise. Global longitudinal strain (LS), LS rate during systole (LSRs), early diastole (LSRe), and late diastole (LSRa) were measured. The symptom-limited cardiopulmonary exercise testing was performed using a cycle ergometer for measuring the peak oxygen consumption (peak \\documentclass[12pt]{minimal}\n\t\t\t\t\\usepackage{amsmath}\n\t\t\t\t\\usepackage{wasysym}\n\t\t\t\t\\usepackage{amsfonts}\n\t\t\t\t\\usepackage{amssymb}\n\t\t\t\t\\usepackage{amsbsy}\n\t\t\t\t\\usepackage{mathrsfs}\n\t\t\t\t\\usepackage{upgreek}\n\t\t\t\t\\setlength{\\oddsidemargin}{-69pt}\n\t\t\t\t\\begin{document}$$ \\dot{V}_{{{\\text{O}}_{2} }} $$\\end{document}).ResultsIn the multivariate linear regression analysis, peak \\documentclass[12pt]{minimal}\n\t\t\t\t\\usepackage{amsmath}\n\t\t\t\t\\usepackage{wasysym}\n\t\t\t\t\\usepackage{amsfonts}\n\t\t\t\t\\usepackage{amssymb}\n\t\t\t\t\\usepackage{amsbsy}\n\t\t\t\t\\usepackage{mathrsfs}\n\t\t\t\t\\usepackage{upgreek}\n\t\t\t\t\\setlength{\\oddsidemargin}{-69pt}\n\t\t\t\t\\begin{document}$$ \\dot{V}_{{{\\text{O}}_{2} }} $$\\end{document} did not associate with strain or strain rate at rest. However, peak \\documentclass[12pt]{minimal}\n\t\t\t\t\\usepackage{amsmath}\n\t\t\t\t\\usepackage{wasysym}\n\t\t\t\t\\usepackage{amsfonts}\n\t\t\t\t\\usepackage{amssymb}\n\t\t\t\t\\usepackage{amsbsy}\n\t\t\t\t\\usepackage{mathrsfs}\n\t\t\t\t\\usepackage{upgreek}\n\t\t\t\t\\setlength{\\oddsidemargin}{-69pt}\n\t\t\t\t\\begin{document}$$ \\dot{V}_{{{\\text{O}}_{2} }} $$\\end{document} correlated with LS (\u03b2\u00a0=\u00a0\u22120.403, p\u00a0=\u00a00.007), LSRe (\u03b2\u00a0=\u00a06.041, p\u00a0=\u00a00.001), and LSRa (\u03b2\u00a0=\u00a05.117, p\u00a0=\u00a00.021) during exercise after adjustment for age, gender, and heart rate. The first quartile peak \\documentclass[12pt]{minimal}\n\t\t\t\t\\usepackage{amsmath}\n\t\t\t\t\\usepackage{wasysym}\n\t\t\t\t\\usepackage{amsfonts}\n\t\t\t\t\\usepackage{amssymb}\n\t\t\t\t\\usepackage{amsbsy}\n\t\t\t\t\\usepackage{mathrsfs}\n\t\t\t\t\\usepackage{upgreek}\n\t\t\t\t\\setlength{\\oddsidemargin}{-69pt}\n\t\t\t\t\\begin{document}$$ \\dot{V}_{{{\\text{O}}_{2} }} $$\\end{document} (14.2\u00a0mL/min/kg) was assessed to predict exercise intolerance. The C-statistic of delta LSRe was 0.74, which was relatively greater than that of delta LS (0.70) and delta LSRa (0.58), indicating that early diastolic function rather than systolic and late diastolic function affects exercise intolerance.ConclusionsLSRe during exercise is closely associated with the peak \\documentclass[12pt]{minimal}\n\t\t\t\t\\usepackage{amsmath}\n\t\t\t\t\\usepackage{wasysym}\n\t\t\t\t\\usepackage{amsfonts}\n\t\t\t\t\\usepackage{amssymb}\n\t\t\t\t\\usepackage{amsbsy}\n\t\t\t\t\\usepackage{mathrsfs}\n\t\t\t\t\\usepackage{upgreek}\n\t\t\t\t\\setlength{\\oddsidemargin}{-69pt}\n\t\t\t\t\\begin{document}$$ \\dot{V}_{{{\\text{O}}_{2} }} $$\\end{document}. Early diastolic function during exercise is an important determinant of exercise capacity in patients with HCM.", 
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    8 schema:description BackgroundHypertrophic cardiomyopathy (HCM) patients with preserved left ventricular ejection fraction (LVEF) often develop dyspnea and exercise intolerance. Diastolic dysfunction may contribute to exercise intolerance in these patients. This study aimed to clarify our hypothesis as to whether diastolic function rather than systolic function would be associated with exercise intolerance in HCM using two-dimensional (2D) speckle tracking echocardiography during exercise.MethodsThirty-three HCM patients (mean age 59.3 ± 15.7 years) underwent 2D speckle tracking echocardiography at rest and during submaximal semi-supine bicycle exercise. Global longitudinal strain (LS), LS rate during systole (LSRs), early diastole (LSRe), and late diastole (LSRa) were measured. The symptom-limited cardiopulmonary exercise testing was performed using a cycle ergometer for measuring the peak oxygen consumption (peak \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}_{{{\text{O}}_{2} }} $$\end{document}).ResultsIn the multivariate linear regression analysis, peak \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}_{{{\text{O}}_{2} }} $$\end{document} did not associate with strain or strain rate at rest. However, peak \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}_{{{\text{O}}_{2} }} $$\end{document} correlated with LS (β = −0.403, p = 0.007), LSRe (β = 6.041, p = 0.001), and LSRa (β = 5.117, p = 0.021) during exercise after adjustment for age, gender, and heart rate. The first quartile peak \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}_{{{\text{O}}_{2} }} $$\end{document} (14.2 mL/min/kg) was assessed to predict exercise intolerance. The C-statistic of delta LSRe was 0.74, which was relatively greater than that of delta LS (0.70) and delta LSRa (0.58), indicating that early diastolic function rather than systolic and late diastolic function affects exercise intolerance.ConclusionsLSRe during exercise is closely associated with the peak \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}_{{{\text{O}}_{2} }} $$\end{document}. Early diastolic function during exercise is an important determinant of exercise capacity in patients with HCM.
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