- 作者：Jing Wang ; Fang Fang ; Gabriel Wai-Kwok Yip ; John E. S ; erson ; Wei Feng ; Jun-Min Xie ; Xiu-Xia Luo ; Cheuk-Man Yu ; Yat-Yin Lam
- 关键词：Left ventricular performance ; HFPEF ; HFREF ; Stress echocardiography
- 刊名：International Journal of Cardiology
- 出版年：15 November, 2013
- 年：2013
- 卷：169
- 期：4
- 页码：311-315
- 全文大小：262 K
Background
We evaluated the left ventricular (LV) performance in patients with heart failure and preserved ejection fraction (HFPEF) during exercise as compared to those with heart failure and reduced ejection fraction (HFREF) and healthy subjects.Methods
All subjects received echocardiographic (Vivid7, GE Healthcare) examination with symptom-limited exercise testing on a semi-recumbent and tilting bicycle ergometer (Lode BV, Netherlands). The exercise images for 2-dimensional (2D) speckle tracking were acquired with heart rate of 90-100 bpm, while exercise images for tissue Doppler imaging (TDI) and M-mode echocardiography were stored with attainment of > 85% of maximal age-predicted heart rate.
Results
Stress echocardiographic examinations were performed in 40 HFPEF (aged 65 卤 9 years; 53% male), 40 HFREF (aged 62 卤 9 years; 90% male) and 30 normal controls (aged 56 卤 5 years; 33% male). Trends of progressive decline in 2D global longitudinal, circumferential and radial strains (GLS, GCS and GRS); TDI septal s鈥?and Sm; and M-mode mitral annular plane systolic excursion (MAPSE) were observed from control, HFPEF to HFREF groups (p < 0.05 for all). LV twist was preserved in HFPEF but reduced in HFREF patients as compared to normal controls (p < 0.05). Diastolic function measured by TDI septal e鈥? Em and septal E/e鈥?progressively decreased from controls, HFPEF to HFREF patients (all p < 0.05). Stroke volumes and cardiac indices (LVSI & LVCI) were preserved in HFPEF but deteriorated in HFREF than controls.
Conclusions
This study provides the reference values of LV performance during exercise in HFPEF and knowledge about these changes provide important insights for future clinical studies.