Exercise Echocardiography of Left Ventricular Diastolic Function in Healthy Subjects: Insights From the RIGHT-NET
Year: 2024
Type: article
Study design: Observational Study
Abstract: Background: Exercise transthoracic Doppler echocardiography (TTE) is considered suggestive of left ventricular (LV) diastolic dysfunction when the ratio of mitral Doppler E to tissue Doppler e' waves is >15 with or without a peak tricuspid regurgitation velocity (TRV) >3.4 m/s. However, these measurements may be affected by exercise intensity. The aim of the study was to define the normal limits of LV diastolic function indices during exercise TTE. Methods: One hundred ninety-two healthy adults (47% females, aged 16-76 years) underwent resting and exercise TTE on a semirecumbent cycle ergometer. LV diastolic measurements were acquired at baseline and midlevel exercise (heart rate ≤110 bpm) fusion of E and A waves. TRV was acquired at rest and at peak exercise. The E/e' ratio was calculated with e' as the average of septal and lateral measurements. Results: < 0.001) as a function of workload and cardiac output (CO), independently of sex and age. The 95th percentile of exercise E/e' was 11.8. The slope of E/e'/CO was 0.4 ± 1.2/L/min. The slope of TRV/CO was 10.8 ± 11.5 cm/s/L/min. The upper 95% confidence interval of the E/e'/CO and TRV/CO slopes were 0.6/L/min and 13.1 cm/s/L/min, corresponding to an E/e' of 13.2 and a TRV of 3.4 m/s at a CO of 15 L/min. Conclusions: In healthy adult subjects, E/e' slightly increased during midlevel exercise. Both E/e' and TRV are exercise intensity-dependent and would therefore be better expressed as a function of CO for the diagnosis of normal vs abnormal LV diastolic response to exercise.
Source: CJC Open
Authors: Francesco Ferrara, Andreina Carbone, Luna Gargani, Rossana Castaldo, Paola Argiento, Gergely Agoston, Rodolfo Citro, Anna D'Agostino, Antonello D’Andrea, Michele D'Alto, Monica Franzese, Stefano Ghio, Ekkehard Grünig, Marco Guazzi, Jarosław D. Kasprzak, Graziella Lacava, Giuseppe Limongelli, Alberto Marra, Matteo Mazzola, Emanuela Passaro, Nicola Riccardo Pugliese, Salvatore Rega, Valeria Visco, Olga Vriz, Karina Wierzbowska-Drabik, Antonio Cittadini, Eduardo Bossone, Robert Naeije
Institutions: AOU San Giovanni di Dio e Ruggi d'Aragona, University of Campania "Luigi Vanvitelli", University of Naples Federico II, University of Pisa, Ospedale Monaldi, University of Szeged, Istituto Neurologico Mediterraneo, Policlinico San Matteo Fondazione, Heidelberg University, University Hospital Heidelberg, University of Milan, Ospedale San Paolo, Medical University of Lodz, University of Salerno, Université Libre de Bruxelles
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,100
Funder: Ministero della Salute
OpenAlex ID: W4404723436