| Autor: |
Shim CY, Kim SA, Choi D, Yang WI, Kim JM, Moon SH, Lee HJ, Park S, Choi EY, Chung N, Ha JW |
| Zdroj: |
Heart; Sep2011, Vol. 97 Issue 17, p1417-1424, 8p |
| Abstrakt: |
Objective To investigate clinical outcomes of exercise-induced pulmonary hypertension (PH) and implications of an increase in left ventricular (LV) filling pressure during exercise in subjects with preserved LV ejection fraction. Design Longitudinal follow-up study. Setting Subjects who were referred for diastolic stress echocardiography. Patients and methods The ratio of transmitral and annular velocities (E/Ea) and pulmonary artery systolic pressure (PASP) at rest and during exercise were measured in 498 subjects (57±11years; 201 male). Exercise-induced PH was defined as present if PASP >=50mm Hg at 50W of exercise, and an increase in LV filling pressure during exercise was present if E/Ea >=15 at 50W. Main outcome measures A combination of major cardiovascular events and any cause of death. Results During a median follow-up of 41months, there were 14 hospitalisations and four deaths. Subjects with exercise-induced PH had significantly worse clinical outcomes than those without (p=0.014). Subjects with exercise-induced PH associated with an increase in E/Ea during exercise had significantly worse outcomes than other groups (p<0.001). However, prognosis was similar between subjects with exercise-induced PH without an increase in E/Ea and those without exercise-induced PH. In subjects with exercise-induced PH, E/Ea at 50W was an independent predictor of adverse outcomes (HR 1.37; 95% CI 1.02 to 1.83; p=0.036). Conclusions Exercise-induced PH provides prognostic information in subjects with preserved LV ejection fraction. The excess risk of exercise-induced PH is restricted to subjects with an increase in estimated LV filling pressure during exercise. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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