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Incremental value of left ventricular diastolic function reserve index for predicting exercise capacity in patients with hypertrophic cardiomyopathy.

Authors
 Eui-Young Choi  ;  Jong-Won Ha  ;  Se-Joong Rim  ;  Sung-Ai Kim  ;  Se-Jung Yoon  ;  Chi-Young Shim  ;  Jin-Mi Kim  ;  Yangsoo Jang  ;  Namsik Chung  ;  Seung-Yun Cho 
Citation
 JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, Vol.21(5) : 487-492, 2008 
Journal Title
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY
ISSN
 0894-7317 
Issue Date
2008
MeSH
Cardiomyopathy,Hypertrophic/blood ; Cardiomyopathy,Hypertrophic/complications ; Cardiomyopathy,Hypertrophic/diagnostic imaging* ; Echocardiography/methods* ; ExerciseTest ; ExerciseTolerance* ; Female ; Fractional FlowReserve, Myocardial* ; Humans ; Image Interpretation, Computer-Assisted/methods* ; Male ; Middle Aged ; Natriuretic Peptide, Brain/blood ; Peptide Fragments/blood ; Reproducibility of Results ; Sensitivity and Specificity ; VentricularDysfunction,Left/blood ; VentricularDysfunction,Left/diagnostic imaging* ; VentricularDysfunction,Left/etiology
Keywords
Cardiomyopathy,Hypertrophic/blood ; Cardiomyopathy,Hypertrophic/complications ; Cardiomyopathy,Hypertrophic/diagnostic imaging* ; Echocardiography/methods* ; ExerciseTest ; ExerciseTolerance* ; Female ; Fractional FlowReserve, Myocardial* ; Humans ; Image Interpretation, Computer-Assisted/methods* ; Male ; Middle Aged ; Natriuretic Peptide, Brain/blood ; Peptide Fragments/blood ; Reproducibility of Results ; Sensitivity and Specificity ; VentricularDysfunction,Left/blood ; VentricularDysfunction,Left/diagnostic imaging* ; VentricularDysfunction,Left/etiology
Abstract
The changes of left ventricular diastolic function during exercise are heterogeneous in patients with hypertrophic cardiomyopathy (HCM). We sought to investigate whether exertional changes of mitral annular velocities and plasma N-terminal-pro-B-type natriuretic peptide (BNP) concentration are associated with exercise capacity in patients with HCM. After a comprehensive echocardiographic study, 32 patients with HCM performed symptom-limited graded supine bicycle exercise. Echocardiographic Doppler parameters were measured at each stage of exercise. Blood samples were collected at rest and immediately after exercise to determine the concentration of pro-BNP. Resting pro-BNP (r = -0.620, P < .001), E'(base) (r = 0.414, P = .018), and DeltaE'(50W) (change of E' from base to 50 W of exercise) (r = 0.367, P = .039) were significantly correlated with exercise duration. Left ventricular longitudinal diastolic function reserve index, defined as DeltaE' x E'(base), significantly correlated with exercise duration (at 50 W, r = 0.540, P = .001) independent of age, sex, body mass index, and resting pro-BNP level. When combining DeltaE' x E'(50W) (<5.85 cm(2)/s(2)) and resting pro-BNP (>740 mg/dL), the predictive accuracy for exercise capacity could be improved (for <500 seconds, global chi(2) = 5.84 in pro-BNP vs 8.10 in pro-BNP + DeltaE' x E'(50W), P = .023). The assessment of left ventricular longitudinal diastolic function reserve can provide incremental information to pro-BNP for the prediction of exercise capacity in patients with HCM.
Full Text
http://www.sciencedirect.com/science/article/pii/S0894731707006268
DOI
10.1016/j.echo.2007.08.041
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sung Ai(김성애)
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Yoon, Se Jung(윤세정)
Rim, Se Joong(임세중) ORCID logo https://orcid.org/0000-0002-7631-5581
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Chung, Nam Sik(정남식)
Cho, Seung Yun(조승연)
Choi, Eui Young(최의영) ORCID logo https://orcid.org/0000-0003-3732-0190
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/106610
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