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http://hdl.handle.net/20.500.12188/8697
Наслов: | Echocardiographic predictors of chronotropic incompetence to exercise in patients with heart failure with preserved ejection fraction | Authors: | Hristovski, Z Projevska-Donegati, D Georgievska-Ismail Lj |
Keywords: | heart failure with preserved ejection fraction diastolic dysfunction left ventricular filling pressure chronotropic incompetence |
Issue Date: | 1-дек-2014 | Publisher: | Macedonian Academy of Sciences and Arts | Journal: | Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki) | Abstract: | Objective: Exercise intolerance in patients with heart failure with preserved ejection fraction (HFpEF) is most often attributed to diastolic dysfunction (DD); however, chronotropic incompetence (CI) could also play an important role. We intended to examine whether there are predictive echocardiographic parameters of DD for impaired chronotropic response to exercise. Methods and Results: Patients (n = 143) with unexplained dyspnea and/or exercise intolerance who fulfilled clinical and echocardiographic criteria of HFpEF presence underwent a symptom-limited exercise test using a treadmill (ETT) according to the Bruce protocol. CI was defined as an achieved heart rate reserve (HRR) of ≤ 80%. Comparison of the groups with (n = 98) and without CI (n = 45) did not show any statistically significant difference regarding demographic and clinical character- ristics except for use of beta blockers (BB) that were more frequently present (p = 0.012) in patients with CI in comparison with those without. Patients with CI had a higher mean E-wave velocity, E/A ratio, increased E/E’ septal, lateral as well as average ratio and abnormal IVRT/TE-e’ index all con- sistent with elevated LV filling pressures. E/E’ average ratio > 15 was statistically insignificantly more frequently present in patients with CI. In addition, by multivariate stepwise regression analysis value of E’ septal (β = 3.697, 95%CI 0.921–6.473, p = 0.009) along with use of BB, current smoking and basal heart rate appeared as statistically significant independent predictors of lower HRR %. Conclusion: Patients with HFpEF frequently have chronotropic incompetence to graded exercise which may partly be predicted with echocardiographic parameters that are consistent with elevated LV filling pressures. | URI: | http://hdl.handle.net/20.500.12188/8697 | DOI: | https://doi.org/10.2478/prilozi-2014-0018 |
Appears in Collections: | Faculty of Medicine: Journal Articles |
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Hristovski - PRILOZI.pdf | 454.57 kB | Adobe PDF | View/Open |
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