Peak exercise myocardial deformation indices during cardiopulmonary exercise testing are associated with exercise capacity and ventilatory efficiency in patients with dilated cardiomyopathy
Little is known about the exercise-induced changes in the multidimensional mechanical properties of the heart. We aimed to evaluate the myocardial deformation indices (MDI) at rest and their response at peak exercise during the same cardiopulmonary exercise testing (CPET) session, investigating thei...
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| Published in: | Hellenic journal of cardiology Vol. 70; pp. 28 - 35 |
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01-03-2023
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| Abstract | Little is known about the exercise-induced changes in the multidimensional mechanical properties of the heart. We aimed to evaluate the myocardial deformation indices (MDI) at rest and their response at peak exercise during the same cardiopulmonary exercise testing (CPET) session, investigating their relationship to exercise capacity and ventilatory sufficiency in dilated cardiomyopathy (DCM) patients.
We evaluated left ventricular (LV) function using speckle tracking imaging (STI) at rest and peak exercise during the same CPET session in 57 idiopathic DCM patients in New York Heart Association (NYHA) I–II class [54 ± 12 years, 42 males, ejection fraction (EF) 33 ± 9%]. We measured global longitudinal strain (GLS), longitudinal strain rate at systole (LSRS) and diastole (LSRD), and circumferential strain rate (CircS).
Resting GLS, LSRS, and LSRD were impaired compared with the predicted values but were improved at peak exercise (p < 0.001). All MDI at rest and/or at peak exercise were related to several CPET-derived parameters, including peak VO2, load, O2 pulse, and VE/VCO2 slope. Peak exercise LSRS > −1.10 sec−1 (AUC = 0.80, p < 0.001) and GLS > −13% (AUC = 0.81, p = 0.002) predicted impaired exercise capacity (peak VO2 < 20 ml/min/kg) and ventilatory inefficiency (VE/VCO2 slope>34). In multiple regression analysis, peak exercise LSRS and GLS were independently related to the peak VO2 (Beta = −0.39, p = 0.003) and VE/VCO2 slope (Beta = 0.35, p = 0.02), respectively.
Peak exercise LSRS and GLS in NYHA I–II DCM patients subjected to CPET were associated with aerobic exercise capacity and ventilatory efficiency. Consequently, LSRS and GLS at peak exercise, through their association with CPET-derived CV risk indices, may underline the severity of heart failure and predict future CV events in this DCM population.
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| AbstractList | Objective: Little is known about the exercise-induced changes in the multidimensional mechanical properties of the heart. We aimed to evaluate the myocardial deformation indices (MDI) at rest and their response at peak exercise during the same cardiopulmonary exercise testing (CPET) session, investigating their relationship to exercise capacity and ventilatory sufficiency in dilated cardiomyopathy (DCM) patients. Methods: We evaluated left ventricular (LV) function using speckle tracking imaging (STI) at rest and peak exercise during the same CPET session in 57 idiopathic DCM patients in New York Heart Association (NYHA) I–II class [54 ± 12 years, 42 males, ejection fraction (EF) 33 ± 9%]. We measured global longitudinal strain (GLS), longitudinal strain rate at systole (LSRS) and diastole (LSRD), and circumferential strain rate (CircS). Results: Resting GLS, LSRS, and LSRD were impaired compared with the predicted values but were improved at peak exercise (p < 0.001). All MDI at rest and/or at peak exercise were related to several CPET-derived parameters, including peak VO2, load, O2 pulse, and VE/VCO2 slope. Peak exercise LSRS > −1.10 sec−1 (AUC = 0.80, p < 0.001) and GLS > −13% (AUC = 0.81, p = 0.002) predicted impaired exercise capacity (peak VO2 < 20 ml/min/kg) and ventilatory inefficiency (VE/VCO2 slope>34). In multiple regression analysis, peak exercise LSRS and GLS were independently related to the peak VO2 (Beta = −0.39, p = 0.003) and VE/VCO2 slope (Beta = 0.35, p = 0.02), respectively. Conclusions: Peak exercise LSRS and GLS in NYHA I–II DCM patients subjected to CPET were associated with aerobic exercise capacity and ventilatory efficiency. Consequently, LSRS and GLS at peak exercise, through their association with CPET-derived CV risk indices, may underline the severity of heart failure and predict future CV events in this DCM population. OBJECTIVELittle is known about the exercise-induced changes in the multidimensional mechanical properties of the heart. We aimed to evaluate the myocardial deformation indices (MDI) at rest and their response at peak exercise during the same cardiopulmonary exercise testing (CPET) session, investigating their relationship to exercise capacity and ventilatory sufficiency in dilated cardiomyopathy (DCM) patients. METHODSWe evaluated left ventricular (LV) function using speckle tracking imaging (STI) at rest and peak exercise during the same CPET session in 57 idiopathic DCM patients in New York Heart Association (NYHA) I-II class [54 ± 12 years, 42 males, ejection fraction (EF) 33 ± 9%]. We measured global longitudinal strain (GLS), longitudinal strain rate at systole (LSRS) and diastole (LSRD), and circumferential strain rate (CircS). RESULTSResting GLS, LSRS, and LSRD were impaired compared with the predicted values but were improved at peak exercise (p < 0.001). All MDI at rest and/or at peak exercise were related to several CPET-derived parameters, including peak VO2, load, O2 pulse, and VE/VCO2 slope. Peak exercise LSRS > -1.10 sec-1 (AUC = 0.80, p < 0.001) and GLS > -13% (AUC = 0.81, p = 0.002) predicted impaired exercise capacity (peak VO2 < 20 ml/min/kg) and ventilatory inefficiency (VE/VCO2 slope>34). In multiple regression analysis, peak exercise LSRS and GLS were independently related to the peak VO2 (Beta = -0.39, p = 0.003) and VE/VCO2 slope (Beta = 0.35, p = 0.02), respectively. CONCLUSIONSPeak exercise LSRS and GLS in NYHA I-II DCM patients subjected to CPET were associated with aerobic exercise capacity and ventilatory efficiency. Consequently, LSRS and GLS at peak exercise, through their association with CPET-derived CV risk indices, may underline the severity of heart failure and predict future CV events in this DCM population. Little is known about the exercise-induced changes in the multidimensional mechanical properties of the heart. We aimed to evaluate the myocardial deformation indices (MDI) at rest and their response at peak exercise during the same cardiopulmonary exercise testing (CPET) session, investigating their relationship to exercise capacity and ventilatory sufficiency in dilated cardiomyopathy (DCM) patients. We evaluated left ventricular (LV) function using speckle tracking imaging (STI) at rest and peak exercise during the same CPET session in 57 idiopathic DCM patients in New York Heart Association (NYHA) I–II class [54 ± 12 years, 42 males, ejection fraction (EF) 33 ± 9%]. We measured global longitudinal strain (GLS), longitudinal strain rate at systole (LSRS) and diastole (LSRD), and circumferential strain rate (CircS). Resting GLS, LSRS, and LSRD were impaired compared with the predicted values but were improved at peak exercise (p < 0.001). All MDI at rest and/or at peak exercise were related to several CPET-derived parameters, including peak VO2, load, O2 pulse, and VE/VCO2 slope. Peak exercise LSRS > −1.10 sec−1 (AUC = 0.80, p < 0.001) and GLS > −13% (AUC = 0.81, p = 0.002) predicted impaired exercise capacity (peak VO2 < 20 ml/min/kg) and ventilatory inefficiency (VE/VCO2 slope>34). In multiple regression analysis, peak exercise LSRS and GLS were independently related to the peak VO2 (Beta = −0.39, p = 0.003) and VE/VCO2 slope (Beta = 0.35, p = 0.02), respectively. Peak exercise LSRS and GLS in NYHA I–II DCM patients subjected to CPET were associated with aerobic exercise capacity and ventilatory efficiency. Consequently, LSRS and GLS at peak exercise, through their association with CPET-derived CV risk indices, may underline the severity of heart failure and predict future CV events in this DCM population. [Display omitted] Little is known about the exercise-induced changes in the multidimensional mechanical properties of the heart. We aimed to evaluate the myocardial deformation indices (MDI) at rest and their response at peak exercise during the same cardiopulmonary exercise testing (CPET) session, investigating their relationship to exercise capacity and ventilatory sufficiency in dilated cardiomyopathy (DCM) patients. We evaluated left ventricular (LV) function using speckle tracking imaging (STI) at rest and peak exercise during the same CPET session in 57 idiopathic DCM patients in New York Heart Association (NYHA) I-II class [54 ± 12 years, 42 males, ejection fraction (EF) 33 ± 9%]. We measured global longitudinal strain (GLS), longitudinal strain rate at systole (LSRS) and diastole (LSRD), and circumferential strain rate (CircS). Resting GLS, LSRS, and LSRD were impaired compared with the predicted values but were improved at peak exercise (p < 0.001). All MDI at rest and/or at peak exercise were related to several CPET-derived parameters, including peak VO , load, O pulse, and VE/VCO slope. Peak exercise LSRS > -1.10 sec (AUC = 0.80, p < 0.001) and GLS > -13% (AUC = 0.81, p = 0.002) predicted impaired exercise capacity (peak VO < 20 ml/min/kg) and ventilatory inefficiency (VE/VCO slope>34). In multiple regression analysis, peak exercise LSRS and GLS were independently related to the peak VO (Beta = -0.39, p = 0.003) and VE/VCO slope (Beta = 0.35, p = 0.02), respectively. Peak exercise LSRS and GLS in NYHA I-II DCM patients subjected to CPET were associated with aerobic exercise capacity and ventilatory efficiency. Consequently, LSRS and GLS at peak exercise, through their association with CPET-derived CV risk indices, may underline the severity of heart failure and predict future CV events in this DCM population. |
| Author | Benas, Dimitrios Makavos, George Iliodromitis, Efstathios K. Birmpa, Dionyssia Triantafyllidi, Helen Triposkiadis, Filippos Cokkinos, Dennis V. Ikonomidis, Ignatios |
| Author_xml | – sequence: 1 givenname: Helen orcidid: 0000-0001-6801-1214 surname: Triantafyllidi fullname: Triantafyllidi, Helen email: seliani@hotmail.com organization: 2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, ATTIKON Hospital, Athens, Greece – sequence: 2 givenname: Dionyssia surname: Birmpa fullname: Birmpa, Dionyssia organization: 2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, ATTIKON Hospital, Athens, Greece – sequence: 3 givenname: Ignatios orcidid: 0000-0001-8241-7886 surname: Ikonomidis fullname: Ikonomidis, Ignatios organization: 2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, ATTIKON Hospital, Athens, Greece – sequence: 4 givenname: Dimitrios orcidid: 0000-0003-4898-2608 surname: Benas fullname: Benas, Dimitrios organization: 2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, ATTIKON Hospital, Athens, Greece – sequence: 5 givenname: George surname: Makavos fullname: Makavos, George organization: 2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, ATTIKON Hospital, Athens, Greece – sequence: 6 givenname: Dennis V. surname: Cokkinos fullname: Cokkinos, Dennis V. organization: Biomedical Research Foundation, Academy of Athens, Athens, Greece – sequence: 7 givenname: Filippos surname: Triposkiadis fullname: Triposkiadis, Filippos organization: Department of Cardiology, Medical School, Larissa University, General Hospital, Larissa, Greece – sequence: 8 givenname: Efstathios K. surname: Iliodromitis fullname: Iliodromitis, Efstathios K. organization: 2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, ATTIKON Hospital, Athens, Greece |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/36586423$$D View this record in MEDLINE/PubMed |
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| Copyright | 2022 Hellenic Society of Cardiology Copyright © 2022 Hellenic Society of Cardiology. Published by Elsevier B.V. All rights reserved. |
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| Keywords | left ventricular myocardial deformation indices cardiopulmonary exercise test (CPET) Dilated cardiomyopathy (DCM) global longitudinal strain (GLS) left ventricular strain rate at systole (LSRS) |
| Language | English |
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| Snippet | Little is known about the exercise-induced changes in the multidimensional mechanical properties of the heart. We aimed to evaluate the myocardial deformation... OBJECTIVELittle is known about the exercise-induced changes in the multidimensional mechanical properties of the heart. We aimed to evaluate the myocardial... Objective: Little is known about the exercise-induced changes in the multidimensional mechanical properties of the heart. We aimed to evaluate the myocardial... |
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| SubjectTerms | Cardiomyopathy, Dilated cardiopulmonary exercise test (CPET) Dilated cardiomyopathy (DCM) Exercise - physiology Exercise Test - methods Exercise Tolerance - physiology global longitudinal strain (GLS) Heart Failure Humans left ventricular myocardial deformation indices left ventricular strain rate at systole (LSRS) Male Oxygen Consumption - physiology Stroke Volume - physiology Ventricular Function, Left - physiology |
| Title | Peak exercise myocardial deformation indices during cardiopulmonary exercise testing are associated with exercise capacity and ventilatory efficiency in patients with dilated cardiomyopathy |
| URI | https://dx.doi.org/10.1016/j.hjc.2022.12.009 https://www.ncbi.nlm.nih.gov/pubmed/36586423 https://search.proquest.com/docview/2759961800 https://doaj.org/article/51f1c48209df4938bf0b4499d18ebb53 |
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