+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Relation of exercise capacity to left ventricular systolic function and diastolic filling in idiopathic or ischemic dilated cardiomyopathy



Relation of exercise capacity to left ventricular systolic function and diastolic filling in idiopathic or ischemic dilated cardiomyopathy



American Journal of Cardiology 83(5): 728-734



Although exercise intolerance is a cardinal symptom of patients with dilated cardiomyopathy (DC) and heart failure, the factors that limit exercise capacity in these patients remain a matter of debate. To assess the contribution of left ventricular (LV) diastolic filling to the variable exercise capacity of patients with DC, we studied 47 patients (60 +- 12 years) with DC in stable mild-to-moderate heart failure with a mean LV ejection fraction of 28%. Exercise capacity was measured as total body peak oxygen consumption (VO2) during symptom-limited bicycle (10 W/min) and treadmill (modified Bruce protocol) exercise. LV systolic function and diastolic filling were assessed at rest before each exercise by M-mode, Doppler echocardiography, and radionuclide ventriculography. As expected, treadmill exercise always yielded higher peak VO2 than bicycle exercise (21 +- 6 vs 18 +- 5 ml/kg/min, range 12 to 35 and 7 to 30 ml/kg/min, respectively, p <0.001). Both of these VO2 measurements were highly reproducible (R = 0.98). With univariate analysis, close correlations were found between peak VO2 (with either exercise modalities) and Doppler indexes of LV diastolic filling, as well as with the radionuclide LV ejection fraction. Stepwise multiple regression analysis identified 3 nonexercise variables as independent correlates of peak VO2, of which the most powerful was the E/A ratio (multiple r2 = 0.38, p < 0.0001), followed by peak A velocity (r2 = 0.54, p <0.0001) and mitral regurgitation grade (r2 = 0.58, p = 0.024). In conclusion, our data indicate that in patients with DC, peak VO2 is better correlated to diastolic filling rather than systolic LV function.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 011273412

Download citation: RISBibTeXText

PMID: 10080427

DOI: 10.1016/s0002-9149(98)00979-5


Related references

Effect of metoprolol on rest and exercise left ventricular systolic and diastolic function in idiopathic dilated cardiomyopathy. American Heart Journal 141(2): 259, 2001

Effects of carvedilol on systolic and diastolic left ventricular performance in idiopathic dilated cardiomyopathy or ischemic cardiomyopathy. American Journal of Cardiology 78(7): 779-784, 1996

Relation of exercise capacity to left ventricular diastolic function in normals and patients with dilated cardiomyopathy. Circulation 82(4 Suppl. 3): III158, 1990

Effects of darbepoetin alpha on right and left ventricular systolic and diastolic function in anemic patients with chronic heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. American Heart Journal 155(4): 751.E1-7, 2008

Exercise capacity and systolic and diastolic ventricular function after recovery from acute dilated cardiomyopathy. Journal Of The American College Of Cardiology. 24(2): 462-470, 1994

Usefulness of isovolumic and systolic ejection signals by tissue Doppler for the assessment of left ventricular systolic function in ischemic or idiopathic dilated cardiomyopathy. American Journal of Cardiology 97(6): 872-875, 2006

Abnormal left ventricular systolic and diastolic functional response to isometric exercise in idiopathic dilated cardiomyopathy: beneficial effect of captopril. Chinese Medical Sciences Journal 10(4): 232-236, 1995

Detecting right ventricular systolic function and exercise capacity in patients with non-ischemic dilated cardiomyopathy. Circulation 106(19 Suppl.): II 686, 2002

Importance of the left ventricular filling pressure on diastolic filling in idiopathic dilated cardiomyopathy. American Journal of Cardiology 64(1): 61-65, 1989

Effects of acute angiotensin-converting enzyme inhibition on left ventricular systolic and diastolic functional response to isometric exercise in idiopathic dilated cardiomyopathy. American Journal of Noninvasive Cardiology 8(2): 63-67, 1994

Impairment of diastolic ventricular function in idiopathic dilated cardiomyopathy in relation to the degree of systolic dysfunction a doppler echocardiographic study. Zeitschrift fuer Kardiologie 80(4): 250-257, 1991

Relation between exercise tolerance and left ventricular diastolic filling in patients with ischemic heart disease and systolic dysfunction. Journal of the American College of Cardiology 21(2 Suppl. A): 329A, 1993

Relation of exercise capacity in dilated cardiomyopathy to left atrial size and systolic function. American Journal of Cardiology 70(7): 825-827, 1992

Relation between left ventricular diastolic function and exercise performance in patients with dilated cardiomyopathy. European Heart Journal 16(ABSTR Suppl. ): 190, 1995

Relation between exercise capacity and left ventricular systolic versus diastolic function during exercise in patients after myocardial infarction. Coronary Artery Disease 12(3): 217-225, 2001