Echocardiography with tissue doppler imaging and cardiopulmonary exercise testing in patients with heart failure: A correlative and prognostic analysis

Marco Guazzi, Jonathan Myers, Mary Ann Peberdy, Daniel Bensimhon, Paul Chase, Sherry Pinkstaff, Ross Arena

Research output: Contribution to journalArticle

Abstract

Background: Previous investigations have established the prognostic value of variables obtained from both echocardiography with tissue Doppler Imaging (TDI) and cardiopulmonary exercise testing (CPX) in patients with heart failure (HF). Past prognostic comparisons of variables obtained from these evaluation techniques have been limited to the comparison of left ventricular ejection fraction (LVEF) vs. peak oxygen consumption (VO2). The present investigation undertakes a more thorough correlative and prognostic assessment. Methods: Two hundred and forty-three patients with HF (190 male/53 female, age: 62.2 ± 9.7) underwent echocardiography with TDI and CPX to determine the following variables: 1) the ratio between mitral early (E) to mitral annular (É) velocity, 2) LVEF, 3) LV mass, 4) LV end systolic volume (LVESV), 5) Peak VO2, 6) The minute ventilation/carbon dioxide production (VE/VCO2) slope, and 7) Exercise oscillatory ventilation (EOV). Results: There were 43 cardiac-related deaths during the four-year tracking period. In the multivariate analysis, E/E′ was the strongest prognostic variable (Chi-square: 46.1, p <0.001). LV mass (Residual chi-square: 16.8, p <0.001), LVESV (Residual chi-square: 8.0, p = 0.005) and the VE/VCO 2 slope (Residual chi-square: 4.6, p = 0.03) all added significant predictive value and were retained in the regression. Conclusions: The results of the present study indicate several variables obtained from echocardiography with TDI are prognostically important in HF. The VE/VCO2 slope, which is one of the strongest prognostic markers obtained from CPX, adds prognostic value to these variables. A combined analysis of both noninvasive techniques may improve the prognostic characterization of patients with HF.

Original languageEnglish
Pages (from-to)323-329
Number of pages7
JournalInternational Journal of Cardiology
Volume143
Issue number3
DOIs
Publication statusPublished - Sep 3 2010

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Echocardiography
Heart Failure
Exercise
Stroke Volume
Ventilation
Residual Volume
Carbon Dioxide
Oxygen Consumption
Multivariate Analysis

Keywords

  • Exercise testing
  • Expired gas
  • Imaging
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Echocardiography with tissue doppler imaging and cardiopulmonary exercise testing in patients with heart failure : A correlative and prognostic analysis. / Guazzi, Marco; Myers, Jonathan; Peberdy, Mary Ann; Bensimhon, Daniel; Chase, Paul; Pinkstaff, Sherry; Arena, Ross.

In: International Journal of Cardiology, Vol. 143, No. 3, 03.09.2010, p. 323-329.

Research output: Contribution to journalArticle

Guazzi, Marco ; Myers, Jonathan ; Peberdy, Mary Ann ; Bensimhon, Daniel ; Chase, Paul ; Pinkstaff, Sherry ; Arena, Ross. / Echocardiography with tissue doppler imaging and cardiopulmonary exercise testing in patients with heart failure : A correlative and prognostic analysis. In: International Journal of Cardiology. 2010 ; Vol. 143, No. 3. pp. 323-329.
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abstract = "Background: Previous investigations have established the prognostic value of variables obtained from both echocardiography with tissue Doppler Imaging (TDI) and cardiopulmonary exercise testing (CPX) in patients with heart failure (HF). Past prognostic comparisons of variables obtained from these evaluation techniques have been limited to the comparison of left ventricular ejection fraction (LVEF) vs. peak oxygen consumption (VO2). The present investigation undertakes a more thorough correlative and prognostic assessment. Methods: Two hundred and forty-three patients with HF (190 male/53 female, age: 62.2 ± 9.7) underwent echocardiography with TDI and CPX to determine the following variables: 1) the ratio between mitral early (E) to mitral annular ({\'E}) velocity, 2) LVEF, 3) LV mass, 4) LV end systolic volume (LVESV), 5) Peak VO2, 6) The minute ventilation/carbon dioxide production (VE/VCO2) slope, and 7) Exercise oscillatory ventilation (EOV). Results: There were 43 cardiac-related deaths during the four-year tracking period. In the multivariate analysis, E/E′ was the strongest prognostic variable (Chi-square: 46.1, p <0.001). LV mass (Residual chi-square: 16.8, p <0.001), LVESV (Residual chi-square: 8.0, p = 0.005) and the VE/VCO 2 slope (Residual chi-square: 4.6, p = 0.03) all added significant predictive value and were retained in the regression. Conclusions: The results of the present study indicate several variables obtained from echocardiography with TDI are prognostically important in HF. The VE/VCO2 slope, which is one of the strongest prognostic markers obtained from CPX, adds prognostic value to these variables. A combined analysis of both noninvasive techniques may improve the prognostic characterization of patients with HF.",
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T2 - A correlative and prognostic analysis

AU - Guazzi, Marco

AU - Myers, Jonathan

AU - Peberdy, Mary Ann

AU - Bensimhon, Daniel

AU - Chase, Paul

AU - Pinkstaff, Sherry

AU - Arena, Ross

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N2 - Background: Previous investigations have established the prognostic value of variables obtained from both echocardiography with tissue Doppler Imaging (TDI) and cardiopulmonary exercise testing (CPX) in patients with heart failure (HF). Past prognostic comparisons of variables obtained from these evaluation techniques have been limited to the comparison of left ventricular ejection fraction (LVEF) vs. peak oxygen consumption (VO2). The present investigation undertakes a more thorough correlative and prognostic assessment. Methods: Two hundred and forty-three patients with HF (190 male/53 female, age: 62.2 ± 9.7) underwent echocardiography with TDI and CPX to determine the following variables: 1) the ratio between mitral early (E) to mitral annular (É) velocity, 2) LVEF, 3) LV mass, 4) LV end systolic volume (LVESV), 5) Peak VO2, 6) The minute ventilation/carbon dioxide production (VE/VCO2) slope, and 7) Exercise oscillatory ventilation (EOV). Results: There were 43 cardiac-related deaths during the four-year tracking period. In the multivariate analysis, E/E′ was the strongest prognostic variable (Chi-square: 46.1, p <0.001). LV mass (Residual chi-square: 16.8, p <0.001), LVESV (Residual chi-square: 8.0, p = 0.005) and the VE/VCO 2 slope (Residual chi-square: 4.6, p = 0.03) all added significant predictive value and were retained in the regression. Conclusions: The results of the present study indicate several variables obtained from echocardiography with TDI are prognostically important in HF. The VE/VCO2 slope, which is one of the strongest prognostic markers obtained from CPX, adds prognostic value to these variables. A combined analysis of both noninvasive techniques may improve the prognostic characterization of patients with HF.

AB - Background: Previous investigations have established the prognostic value of variables obtained from both echocardiography with tissue Doppler Imaging (TDI) and cardiopulmonary exercise testing (CPX) in patients with heart failure (HF). Past prognostic comparisons of variables obtained from these evaluation techniques have been limited to the comparison of left ventricular ejection fraction (LVEF) vs. peak oxygen consumption (VO2). The present investigation undertakes a more thorough correlative and prognostic assessment. Methods: Two hundred and forty-three patients with HF (190 male/53 female, age: 62.2 ± 9.7) underwent echocardiography with TDI and CPX to determine the following variables: 1) the ratio between mitral early (E) to mitral annular (É) velocity, 2) LVEF, 3) LV mass, 4) LV end systolic volume (LVESV), 5) Peak VO2, 6) The minute ventilation/carbon dioxide production (VE/VCO2) slope, and 7) Exercise oscillatory ventilation (EOV). Results: There were 43 cardiac-related deaths during the four-year tracking period. In the multivariate analysis, E/E′ was the strongest prognostic variable (Chi-square: 46.1, p <0.001). LV mass (Residual chi-square: 16.8, p <0.001), LVESV (Residual chi-square: 8.0, p = 0.005) and the VE/VCO 2 slope (Residual chi-square: 4.6, p = 0.03) all added significant predictive value and were retained in the regression. Conclusions: The results of the present study indicate several variables obtained from echocardiography with TDI are prognostically important in HF. The VE/VCO2 slope, which is one of the strongest prognostic markers obtained from CPX, adds prognostic value to these variables. A combined analysis of both noninvasive techniques may improve the prognostic characterization of patients with HF.

KW - Exercise testing

KW - Expired gas

KW - Imaging

KW - Prognosis

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