Left ventricular chamber stiffness at rest as a determinant of exercise capacity in heart failure subjects with decreased ejection fraction.
Left ventricular chamber stiffness at rest as a determinant of exercise capacity in heart failure subjects with decreased ejection fraction.
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静息时左心室硬度是射血分数降低的心力衰竭受试者运动能力的决定因素。
DOI：
10.1152/japplphysiol.00078.2004
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发表时间：
2004
期刊：
影响因子：
--
通讯作者：
Kovacs,SandorJ
中科院分区：
文献类型：
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作者：
Meyer,TimothyE;Karamanoglu,Mustafa;Ehsani,AliA;Kovacs,SandorJ
运动耐量受损（由峰值耗氧量（V ~ o2 peak）确定）可预测慢性心力衰竭（HF）患者的死亡率和心脏移植的必要性。然而，左心室（LV）舒张功能在静息状态下的作用，反映了超声心动图评估的腔室硬度，作为运动耐量的决定因素是未知的。左心室僵硬度增加和V_（to 2）峰值受限是已知的HF相关因素。然而，心室刚度和HF受试者的V_（to 2）峰值之间的关系尚未完全确定。41例纽约心脏协会（NYHA）分级为2.4 ± 0.8，平均值±标准差（SD）的HF患者进行了超声心动图检查和V现代o2峰值测量。使用先前确认的方法分析经二尖瓣多普勒E波，以确定LV腔室刚度参数。多元线性回归分析表明，左室僵硬度k（r2= 0.55）和NYHA心功能分级（r2= 0.43）是最好的独立预测因子，两者共同解释了V_（to 2）峰值变异性的59%。我们的结论是，舒张功能在休息时，表现为室硬度，是一个主要的决定因素，最大的运动能力在HF。
Impaired exercise tolerance, determined by peak oxygen consumption (V̇o2 peak), is predictive of mortality and the necessity for cardiac transplantation in patients with chronic heart failure (HF). However, the role of left ventricular (LV) diastolic function at rest, reflected by chamber stiffness assessed echocardiographically, as a determinant of exercise tolerance is unknown. Increased LV chamber stiffness and limitation of V̇o2 peakare known correlates of HF. Yet, the relationship between chamber stiffness and V̇o2 peakin subjects with HF has not been fully determined. Forty-one patients with HF New York Heart Association [(NYHA) class 2.4 ± 0.8, mean ± SD] had echocardiographic studies and V̇o2 peakmeasurements. Transmitral Doppler E waves were analyzed using a previously validated method to determinek, the LV chamber stiffness parameter. Multiple linear regression analysis of V̇o2 peakvariance indicated that LV chamber stiffnessk(r2= 0.55) and NYHA classification (r2= 0.43) were its best independent predictors and when taken together account for 59% of the variability in V̇o2 peak. We conclude that diastolic function at rest, as manifested by chamber stiffness, is a major determinant of maximal exercise capacity in HF.