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Diastolic Stress Echocardiography:A Novel Noninvasive Diagnostic Test for Diastolic Dysfunction Using Supine Bicycle ExerciseDoppler Echocardiography

Authors
 Jong-Won Ha  ;  Jae K. Oh  ;  Patricia A. Pellikka  ;  Steve R. Ommen  ;  Vicky L. Stussy  ;  Kent R. Bailey  ;  James B. Seward  ;  A. Jamil Tajik 
Citation
 JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, Vol.18(1) : 63-68, 2005 
Journal Title
 JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY 
ISSN
 0894-7317 
Issue Date
2005
MeSH
Adult ; Aged ; Aged, 80 and over ; Blood Flow Velocity ; Diastole ; Echocardiography, Doppler/methods* ; Exercise Test ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Ventricular Dysfunction, Left/diagnostic imaging ; Ventricular Function, Left*
Keywords
15637491
Abstract
Left ventricular filling pressures can be estimated reliably by combining mitral inflow early diastolic velocity (E) and annulus velocity (E'). An increased E/E' ratio reflects elevated filling pressures and may be useful in assessing an abnormal increase in filling pressures for patients with diastolic dysfunction. The purpose of this study was to evaluate the feasibility of supine bicycle exercise Doppler echocardiography for assessing left ventricular diastolic pressure during exercise. Mitral inflow and septal mitral annulus velocities were measured at rest and during supine bicycle exercise (25-W 3-minute increments) in 45 patients (19 men; mean age, 59 years) referred for evaluation of exertional dyspnea. None had echocardiographic or electrocardiographic evidence of myocardial ischemia with exercise. Patients were classified according to E/E' ratio at rest: 26 had E/E' < or = 10 at rest (group 1) and 19 had E/E' > 10 (group 2). For group 1, 17 had no increase in E/E' during exercise (group 1A) and 9 did (group 1B). For group 2, E/E' did not increase during exercise. Despite different responses of E/E', there was no significant difference in changes of mitral inflow indices (E, A, E/A, deceleration time) between groups. Although the percentage of dyspnea as a primary reason for stopping exercise was similar for the groups, exercise duration was significantly shorter for groups 1B (7.2 +/- 2.5 minutes) and 2 (7.1 +/- 3.3 minutes) than in group 1A (10.4 +/- 3.7 minutes, P = .0129). Diastolic stress echocardiography using a supine bicycle is technically feasible for demonstrating changes in E/E' (filling pressure) with exercise. Our preliminary results suggest the hemodynamic consequences of exercise-induced increase in diastolic filling pressure can be demonstrated noninvasively with exercise Doppler echocardiography.
Full Text
http://www.sciencedirect.com/science/article/pii/S0894731704007722
DOI
10.1016/j.echo.2004.08.033
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151077
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