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Role of Diastolic Function in Preserved Exercise Capacity in Patients with Reduced Ejection Fractions.

Publication ,  Journal Article
Ohara, T; Iwano, H; Thohan, V; Kitzman, DW; Upadhya, B; Pu, M; Little, WC
Published in: J Am Soc Echocardiogr
October 2015

BACKGROUND: Some patients with markedly reduced ejection fractions (EFs) (<35%) have preserved exercise performance greater than predicted for age and gender. Because diastolic function may be a determinant of exercise performance, this study was conducted to test the hypothesis that patients with preserved exercise tolerance despite EFs < 35% may have relatively normal diastolic function. 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%).

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Published In

J Am Soc Echocardiogr

DOI

EISSN

1097-6795

Publication Date

October 2015

Volume

28

Issue

10

Start / End Page

1184 / 1193

Location

United States

Related Subject Headings

  • Stroke Volume
  • Sex Factors
  • Role
  • Risk Assessment
  • Retrospective Studies
  • Reference Standards
  • ROC Curve
  • Prognosis
  • Predictive Value of Tests
  • Middle Aged
 

Citation

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ICMJE
MLA
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Ohara, T., Iwano, H., Thohan, V., Kitzman, D. W., Upadhya, B., Pu, M., & Little, W. C. (2015). Role of Diastolic Function in Preserved Exercise Capacity in Patients with Reduced Ejection Fractions. J Am Soc Echocardiogr, 28(10), 1184–1193. https://doi.org/10.1016/j.echo.2015.06.004
Ohara, Takahiro, Hiroyuki Iwano, Vinay Thohan, Dalane W. Kitzman, Bharathi Upadhya, Min Pu, and William C. Little. “Role of Diastolic Function in Preserved Exercise Capacity in Patients with Reduced Ejection Fractions.J Am Soc Echocardiogr 28, no. 10 (October 2015): 1184–93. https://doi.org/10.1016/j.echo.2015.06.004.
Ohara T, Iwano H, Thohan V, Kitzman DW, Upadhya B, Pu M, et al. Role of Diastolic Function in Preserved Exercise Capacity in Patients with Reduced Ejection Fractions. J Am Soc Echocardiogr. 2015 Oct;28(10):1184–93.
Ohara, Takahiro, et al. “Role of Diastolic Function in Preserved Exercise Capacity in Patients with Reduced Ejection Fractions.J Am Soc Echocardiogr, vol. 28, no. 10, Oct. 2015, pp. 1184–93. Pubmed, doi:10.1016/j.echo.2015.06.004.
Ohara T, Iwano H, Thohan V, Kitzman DW, Upadhya B, Pu M, Little WC. Role of Diastolic Function in Preserved Exercise Capacity in Patients with Reduced Ejection Fractions. J Am Soc Echocardiogr. 2015 Oct;28(10):1184–1193.
Journal cover image

Published In

J Am Soc Echocardiogr

DOI

EISSN

1097-6795

Publication Date

October 2015

Volume

28

Issue

10

Start / End Page

1184 / 1193

Location

United States

Related Subject Headings

  • Stroke Volume
  • Sex Factors
  • Role
  • Risk Assessment
  • Retrospective Studies
  • Reference Standards
  • ROC Curve
  • Prognosis
  • Predictive Value of Tests
  • Middle Aged