Prognostic value of E/e ratio changes with exercise in symptomatic patients referred for exercise echocardiography

Autor: J Peteiro, A Bouzas-Mosquera, C Barbeito-Caamano, B Souto-Cainzos, E Martin-Alvarez, M Bas-Gonzalez, JM Vazquez-Rodriguez
Rok vydání: 2022
Předmět:
Zdroj: European Heart Journal - Cardiovascular Imaging. 23
ISSN: 2047-2412
2047-2404
Popis: Funding Acknowledgements Type of funding sources: None. Background We have previously noticed that some patients with decrease of the ratio of early LV inflow velocity to early tissue Doppler annulus velocity (E/e`) with exercise might have better outcome than others that exhibit raised values at both rest and exercise. In this research, we aimed to assess the prognostic value of E/e´ change with exercise in patients with normal or abnormal resting diastolic function (DF) referred for a clinically indicated ExE. Methods LV systolic and diastolic function (DF) according to ASE/EACVI guidelines, were evaluated at rest in 750 patients (age 67 ± 12 years) with preserved LV ejection fraction (≥50). We assessed regional/global LV systolic function at peak exercise, while E/e’ was evaluated in the immediate post-exercise period. Abnormal ExE was defined as ischemia or fixed wall motion abnormalities, and raised E/e´values as >15 at rest and at exercise (e´ at the septal level). Patients were grouped as having raised E/e´ at both rest and exercise (R-RestEx, n = 77), raised E/e´ only at exercise (R-Ex, n = 47), raised only at rest (R-Rest, n = 71) and non-raised (NR, n = 555). Events were overall mortality, myocardial infarction, admission for unstable angina or cardiac failure, coronary revascularization, pulmonary thromboembolism, and stroke. Results Abnormal resting DF was present in 219 patients (29%), indeterminate in 70 (9%). Percentages of abnormal resting DF were 13% in group NR, 90% in group R-Rest, 28% in group R-Ex and 88% in group R-RestEx (p Conclusions E/e´ changes during exercise may help to reclassify risk of patients. Patients with normal E/e´ values at exercise have better outcome, despite resting values. Abstract Figure.
Databáze: OpenAIRE
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