Role of diastolic function in preserved exercise capacity in patients with reduced ejection fractions
Ohara T, Iwano H, Thohan V, et al. Role of Diastolic Function in Preserved Exercise Capacity in Patients with Reduced Ejection Fractions. J Am Soc Echocardiogr. 2015;28(10):1184-93. doi: 10.1016/j.echo.2015.06.004
BACKGROUND: Some patients with markedly reduced ejection fractions (EFs) (
METHODS: Sixty-five subjects with EFs < 35% who underwent exercise Doppler echocardiography and had no inducible ischemia were retrospectively examined. Forty-five subjects with normal EFs (>60%) and preserved exercise capacity were analyzed as a control group.
RESULTS: Sixteen of 65 patients with EFs < 35% had greater than predicted normal exercise capacity for their age and gender, and the remaining 49 patients had reduced exercise capacity. Patients with reduced EFs and preserved exercise capacity had E/e' ratios (mean, 10 ± 4) similar to those of control subjects (mean, 10 ± 3) and lower than those with reduced exercise tolerance (mean, 16 ± 8) (P < .01). In addition, they had better diastolic filling patterns and smaller left atrial sizes than patients with EFs < 35% and reduced exercise capacity. Multivariate logistic regression analyses indicated that E/e' ratio was an independent predictor of preserved exercise capacity in patients with reduced EFs.
CONCLUSIONS: Relatively intact diastolic function contributes to preserved exercise capacity in patients with reduced EFs (<35%).