| Přispěvatelé: |
D'Andrea, A, Gravino, R, Salerno, G, Padalino, R, Riegler, L, Scarafile, R, Pezzullo, E, Nunziata, L, Romano, M, Limongelli, G, Bossone, E, Pacileo, G, Caso, P, Russo, Mg, Calabrò, R., D'Andrea, A., Gravino, R., Salerno, G., Padalino, R., Riegler, L., Scarafile, R., Pezzullo, E., Nunziata, L., Romano, M., Limongelli, G., Bossone, E., Pacileo, G., Caso, P., Russo, M. G., Calabro, R. |
| Popis: |
Objectives: The aim of the study was to detect if right ventricular (RV) ejection fraction assessed by real-time 3D echocardiography (RT3DE) could predict patients with dilated cardiomyopathy (DCM) with greater functional impairment in response to cardiopulmonary exercise. Materials and methods: 55 chronic heart failure patients with DCM (56.5 ± 9.1 years; 40 males; 30 ischaemic; NYHA class III: 40) and 30 healthy controls underwent both left ventricular (LV) and RV analysis by RT3DE. Post-processing software provided data of RT3DE systolic dyssynchrony index (SDI) of 16 LV segments, and of both LV and RV ejection fraction. Cardiac magnetic resonance was performed in a subgroup of 20 DCM patients to confirm RT3DE measurements. DCM patients underwent also bicycle cardiopulmonary exercise test with evaluation of VO 2 peak (percentage of the predicted value), VE/VCO 2 slope and circulatory power (CP). Results: In DCM patients mean LV ejection fraction was 29.8 ± 4.6%. RT3DE LV SDI was 8.4.4 ± 4.2, and RV ejection fraction was 51.3 ± 4.6%. By cardiopulmonary test, mean VO 2 peak was 15.2 ± 4.4 mL/kg/min, and mean CP was 2.1 ± 0.8. By univariable analysis, RV ejection fraction directly correlated with VO 2 peak % (r = 0,55; p < 0.0001) and inversely with VE/VCO 2 slope (r = -0.42; p < 0.001). By multivariable analysis, SDI (beta coefficient = -0.46; p < 0.001) and 3D RV ejection fraction (beta coefficient = 0.42; p < 0.001) emerged as the only independent determinant of VO 2 peak % during cardiopulmonary test. Conclusions: Impaired RV function in DCM patients is independently associated with worse ability to perform aerobic exercise. © 2011 Società Italiana di Ecografia Cardiovascolare. Published by Elsevier Srl. All rights reserved. |
