Purpose: Heart failure (HF) is a multifactorial entity that combines derangements in both systolic and diastolic function. The relationship between systolic and diastolic function and exercise capacity is not fully understood. We sought to determine the mechanisms linking cardiac function and exercise tolerance in patients with HF.
Methods: One hundred fifty-six subjects with different cardiac function levels were included in the study. Subjects' 2D echocardiographic, 3D speckle tracking echocardiographic, and cardiopulmonary exercise testing (CPET) data were collected.
Result: The amount of untwisting at 25% of the untwist duration (25%Untwist) and global longitudinal peak systolic strain (GLS) showed the best positive correlations with peak oxygen uptake (peakVO ) (r = .41; P < .001 and r = .32; P < .001, respectively), while the left ventricular ejection fraction (EF) was weakly correlated with peakVO . The 25%Untwist value was negatively correlated with the carbon dioxide equivalent slope (VE/VCO ) (r = -.49; P < .001). Both E/e and the left atrium volume index (LA index) exhibited good positive correlations with VE/VCO (r = .39; P < .01 and r = .32; P < .001). In the multiple regression analysis, the best predictive model for the peakVO included the 25%Untwist, GLS, and E/e, explained 64% of the variation in peakVO , with 25%Untwist explaining 17.6% of the variation. Including EF in the model explained only 3.1% of the variation in peakVO . In a multivariable model for VE/VCO , 25%Untwist was the strongest independent predictor, explaining 23% of the variance in VE/VCO .
Conclusion: Left ventricular early diastolic function is a modest independent predictor of aerobic exercise capacity. The 25%Untwist value is a good indicator of cardiac diastolic function.
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http://dx.doi.org/10.1111/echo.13675 | DOI Listing |
Diagnostics (Basel)
December 2024
Cardiology and Intensive Care Unit, Department of Cardiology, "Umberto I" Hospital, 84014 Nocera Inferiore, Italy.
Interest in advanced echocardiographic imaging methods is growing. Left atrial strain (LAS) is among recently developed echocardiographic parameters. LAS represents an index of tissue deformation of the left atrium (LA).
View Article and Find Full Text PDFCardiovasc Diagn Ther
December 2024
Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary.
Background: Dextro-transposition of the great arteries (dTGA) stands out as a prevalent cyanotic congenital heart defect (CHD), characterized by an intricate reversal in the arrangement of the major arteries. In the past, several surgical procedures have been used to treat dTGA, including the atrial switch. Although the method is no longer used, survivors of the procedure still living among us.
View Article and Find Full Text PDFChin Med Sci J
November 2024
State Key Laboratory for Innovation and Transformation of Luobing Theory; Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences; Department of Cardiology, Qilu Hospital of Shandong University, Jinan 250012, China.
Objectives: To investigate the predictive value of myocardial strain for cardiotoxicity associated with fluorouracil-based chemotherapies in gastrointestinal cancer patients.
Methods: Patients with diagnosis of gastrointestinal cancers, who were hospitalized for chemotherapy involving antimetabolic drugs, were eligible in this prospective study. Echocardiography was performed before and after each chemotherapy cycle during hospitalization until the completion of chemotherapy.
J Ultrasound Med
January 2025
Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado, USA.
Objectives: The size, shape, and contractility of the heart's atrial chambers have not been evaluated in fetuses with growth restriction (FGR) or who are small-for-gestational-age (SGA) as defined by the Delphi consensus protocol. This study aimed to examine the atrial chambers using speckle tracking analysis to identify any changes that may be specific for either growth disturbance.
Methods: Sixty-three fetuses were evaluated with an estimated fetal weight <10th percentile who were classified as FGR or SGA based on the Delphi consensus protocol.
Echocardiography
January 2025
Department of Clinical, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
Transcatheter aortic valve implantation (TAVI) is the main treatment option for patients with severe aortic stenosis (AS) and older age. Improved imaging techniques have enabled better patient selection, and the main role is played by echocardiography. Methods more sensitive than LVEF in assessing cardiac function, such as global longitudinal strain (GLS) and myocardial work (MW), have become widespread, and other methods, like hemodynamic forces (HDFs), might be promising.
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