Coronary flow reserve as a link between diastolic and systolic function and exercise capacity in heart failure
In heart failure, a reduced exercise capacity is the prevailing symptom and an important prognostic marker of future outcome. The purpose of the study was to assess the relation of coronary flow reserve (CFR) to diastolic and systolic function in heart failure and to determine which are the limiting...
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| Veröffentlicht in: | European heart journal cardiovascular imaging 2013-07, Vol.14 (7), p.677-683 |
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| container_title | European heart journal cardiovascular imaging |
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| creator | Snoer, Martin Monk-Hansen, Tea Olsen, Rasmus Huan Pedersen, Lene Roerholm Nielsen, Olav Wendelboe Rasmusen, Hanne Dela, Flemming Prescott, Eva |
| description | In heart failure, a reduced exercise capacity is the prevailing symptom and an important prognostic marker of future outcome. The purpose of the study was to assess the relation of coronary flow reserve (CFR) to diastolic and systolic function in heart failure and to determine which are the limiting factors for exercise capacity.
Forty-seven patients with left ventricular ejection fraction (LVEF) |
| doi_str_mv | 10.1093/ehjci/jes269 |
| format | Article |
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Forty-seven patients with left ventricular ejection fraction (LVEF) <35 [median LVEF 31 (inter-quartile range 26-34)] underwent cardiorespiratory exercise test with measurement of VO2 peak, a dual X-ray absorptiometry scan for body composition, and a full echocardiography with measurement of LVEF using the biplane Simpson model, mitral inflow velocities, and pulsed wave tissue Doppler. Peak coronary flow velocity (CFV) was measured in the LAD, using pulsed-wave Doppler. CFR was calculated as the ratio between peak CFV at rest and during 2 min of adenosine stress. Fat-free-mass-adjusted VO2 peak correlated significantly with CFR (r = 0.48, P = 0.002), E/e' (r = -0.35, P = 0.02), and s' (r = 0.45, P = 0.001) but not with LVEF (r = 0.23, P = 0.11). CFR correlated significantly with E/e' (r = -0.46, P = 0.003) and s' (r = 0.36, P = 0.02), but not with LVEF (r = 0.18, P = 0.26). When adjusting for CFR in a multivariable linear model, s' but not E/e' remained independently associated with VO2 peak.
In this group of heart failure patients, VO2 peak was correlated with CFR, E/e', and s' but not with traditional measures of systolic function. CFR remained associated with VO2 peak independently of diastolic and systolic function and is likely to be a limiting factor in functional capacity of heart failure patients.</description><identifier>ISSN: 2047-2404</identifier><identifier>EISSN: 2047-2412</identifier><identifier>DOI: 10.1093/ehjci/jes269</identifier><identifier>PMID: 23169759</identifier><language>eng</language><publisher>England</publisher><subject>Aged ; Body Composition ; Chi-Square Distribution ; Coronary Circulation - physiology ; Diastole - physiology ; Echocardiography, Doppler, Color - methods ; Echocardiography, Doppler, Pulsed - methods ; Exercise - physiology ; Exercise Test - methods ; Exercise Tolerance - physiology ; Female ; Fractional Flow Reserve, Myocardial ; Heart Failure, Systolic - diagnosis ; Heart Failure, Systolic - therapy ; Humans ; Linear Models ; Male ; Middle Aged ; Multivariate Analysis ; Oxygen Consumption - physiology ; Prognosis ; Pulse Wave Analysis ; Severity of Illness Index ; Statistics, Nonparametric ; Stroke Volume ; Systole - physiology</subject><ispartof>European heart journal cardiovascular imaging, 2013-07, Vol.14 (7), p.677-683</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c329t-49ef4203a4a4dd46fa561f0517875bbc2d66450a0d2b99889e95d59194698ad83</citedby><cites>FETCH-LOGICAL-c329t-49ef4203a4a4dd46fa561f0517875bbc2d66450a0d2b99889e95d59194698ad83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23169759$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Snoer, Martin</creatorcontrib><creatorcontrib>Monk-Hansen, Tea</creatorcontrib><creatorcontrib>Olsen, Rasmus Huan</creatorcontrib><creatorcontrib>Pedersen, Lene Roerholm</creatorcontrib><creatorcontrib>Nielsen, Olav Wendelboe</creatorcontrib><creatorcontrib>Rasmusen, Hanne</creatorcontrib><creatorcontrib>Dela, Flemming</creatorcontrib><creatorcontrib>Prescott, Eva</creatorcontrib><title>Coronary flow reserve as a link between diastolic and systolic function and exercise capacity in heart failure</title><title>European heart journal cardiovascular imaging</title><addtitle>Eur Heart J Cardiovasc Imaging</addtitle><description>In heart failure, a reduced exercise capacity is the prevailing symptom and an important prognostic marker of future outcome. The purpose of the study was to assess the relation of coronary flow reserve (CFR) to diastolic and systolic function in heart failure and to determine which are the limiting factors for exercise capacity.
Forty-seven patients with left ventricular ejection fraction (LVEF) <35 [median LVEF 31 (inter-quartile range 26-34)] underwent cardiorespiratory exercise test with measurement of VO2 peak, a dual X-ray absorptiometry scan for body composition, and a full echocardiography with measurement of LVEF using the biplane Simpson model, mitral inflow velocities, and pulsed wave tissue Doppler. Peak coronary flow velocity (CFV) was measured in the LAD, using pulsed-wave Doppler. CFR was calculated as the ratio between peak CFV at rest and during 2 min of adenosine stress. Fat-free-mass-adjusted VO2 peak correlated significantly with CFR (r = 0.48, P = 0.002), E/e' (r = -0.35, P = 0.02), and s' (r = 0.45, P = 0.001) but not with LVEF (r = 0.23, P = 0.11). CFR correlated significantly with E/e' (r = -0.46, P = 0.003) and s' (r = 0.36, P = 0.02), but not with LVEF (r = 0.18, P = 0.26). When adjusting for CFR in a multivariable linear model, s' but not E/e' remained independently associated with VO2 peak.
In this group of heart failure patients, VO2 peak was correlated with CFR, E/e', and s' but not with traditional measures of systolic function. CFR remained associated with VO2 peak independently of diastolic and systolic function and is likely to be a limiting factor in functional capacity of heart failure patients.</description><subject>Aged</subject><subject>Body Composition</subject><subject>Chi-Square Distribution</subject><subject>Coronary Circulation - physiology</subject><subject>Diastole - physiology</subject><subject>Echocardiography, Doppler, Color - methods</subject><subject>Echocardiography, Doppler, Pulsed - methods</subject><subject>Exercise - physiology</subject><subject>Exercise Test - methods</subject><subject>Exercise Tolerance - physiology</subject><subject>Female</subject><subject>Fractional Flow Reserve, Myocardial</subject><subject>Heart Failure, Systolic - diagnosis</subject><subject>Heart Failure, Systolic - therapy</subject><subject>Humans</subject><subject>Linear Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Oxygen Consumption - physiology</subject><subject>Prognosis</subject><subject>Pulse Wave Analysis</subject><subject>Severity of Illness Index</subject><subject>Statistics, Nonparametric</subject><subject>Stroke Volume</subject><subject>Systole - physiology</subject><issn>2047-2404</issn><issn>2047-2412</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kD1PwzAQhi0EolXpxow8MhBqO45jj6jiS6rEAnPk2GfVJXWKnVD67wlt6S137-nROzwIXVNyT4nKZ7BcGT9bQWJCnaExI7zMGKfs_HQTPkLTlFZkmIILzuglGrGcClUWaozCvI1t0HGHXdNucYQE8RuwTljjxodPXEO3BQjYep26tvEG62Bx2h2D64PpfBv2X_iBaHwCbPRGG9_tsA94CTp22Gnf9BGu0IXTTYLpcU_Qx9Pj-_wlW7w9v84fFpnJmeoyrsBxRnLNNbeWC6cLQR0paCnLoq4Ns0LwgmhiWa2UlApUYQtFFRdKaivzCbo99G5i-9VD6qq1TwaaRgdo-1TRXJRSslySAb07oCa2KUVw1Sb69WCkoqT6k1ztJVcHyQN-c2zu6zXYE_yvNP8FhyN6MA</recordid><startdate>201307</startdate><enddate>201307</enddate><creator>Snoer, Martin</creator><creator>Monk-Hansen, Tea</creator><creator>Olsen, Rasmus Huan</creator><creator>Pedersen, Lene Roerholm</creator><creator>Nielsen, Olav Wendelboe</creator><creator>Rasmusen, Hanne</creator><creator>Dela, Flemming</creator><creator>Prescott, Eva</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201307</creationdate><title>Coronary flow reserve as a link between diastolic and systolic function and exercise capacity in heart failure</title><author>Snoer, Martin ; Monk-Hansen, Tea ; Olsen, Rasmus Huan ; Pedersen, Lene Roerholm ; Nielsen, Olav Wendelboe ; Rasmusen, Hanne ; Dela, Flemming ; Prescott, Eva</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c329t-49ef4203a4a4dd46fa561f0517875bbc2d66450a0d2b99889e95d59194698ad83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Body Composition</topic><topic>Chi-Square Distribution</topic><topic>Coronary Circulation - physiology</topic><topic>Diastole - physiology</topic><topic>Echocardiography, Doppler, Color - methods</topic><topic>Echocardiography, Doppler, Pulsed - methods</topic><topic>Exercise - physiology</topic><topic>Exercise Test - methods</topic><topic>Exercise Tolerance - physiology</topic><topic>Female</topic><topic>Fractional Flow Reserve, Myocardial</topic><topic>Heart Failure, Systolic - diagnosis</topic><topic>Heart Failure, Systolic - therapy</topic><topic>Humans</topic><topic>Linear Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Oxygen Consumption - physiology</topic><topic>Prognosis</topic><topic>Pulse Wave Analysis</topic><topic>Severity of Illness Index</topic><topic>Statistics, Nonparametric</topic><topic>Stroke Volume</topic><topic>Systole - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Snoer, Martin</creatorcontrib><creatorcontrib>Monk-Hansen, Tea</creatorcontrib><creatorcontrib>Olsen, Rasmus Huan</creatorcontrib><creatorcontrib>Pedersen, Lene Roerholm</creatorcontrib><creatorcontrib>Nielsen, Olav Wendelboe</creatorcontrib><creatorcontrib>Rasmusen, Hanne</creatorcontrib><creatorcontrib>Dela, Flemming</creatorcontrib><creatorcontrib>Prescott, Eva</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal cardiovascular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Snoer, Martin</au><au>Monk-Hansen, Tea</au><au>Olsen, Rasmus Huan</au><au>Pedersen, Lene Roerholm</au><au>Nielsen, Olav Wendelboe</au><au>Rasmusen, Hanne</au><au>Dela, Flemming</au><au>Prescott, Eva</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Coronary flow reserve as a link between diastolic and systolic function and exercise capacity in heart failure</atitle><jtitle>European heart journal cardiovascular imaging</jtitle><addtitle>Eur Heart J Cardiovasc Imaging</addtitle><date>2013-07</date><risdate>2013</risdate><volume>14</volume><issue>7</issue><spage>677</spage><epage>683</epage><pages>677-683</pages><issn>2047-2404</issn><eissn>2047-2412</eissn><abstract>In heart failure, a reduced exercise capacity is the prevailing symptom and an important prognostic marker of future outcome. The purpose of the study was to assess the relation of coronary flow reserve (CFR) to diastolic and systolic function in heart failure and to determine which are the limiting factors for exercise capacity.
Forty-seven patients with left ventricular ejection fraction (LVEF) <35 [median LVEF 31 (inter-quartile range 26-34)] underwent cardiorespiratory exercise test with measurement of VO2 peak, a dual X-ray absorptiometry scan for body composition, and a full echocardiography with measurement of LVEF using the biplane Simpson model, mitral inflow velocities, and pulsed wave tissue Doppler. Peak coronary flow velocity (CFV) was measured in the LAD, using pulsed-wave Doppler. CFR was calculated as the ratio between peak CFV at rest and during 2 min of adenosine stress. Fat-free-mass-adjusted VO2 peak correlated significantly with CFR (r = 0.48, P = 0.002), E/e' (r = -0.35, P = 0.02), and s' (r = 0.45, P = 0.001) but not with LVEF (r = 0.23, P = 0.11). CFR correlated significantly with E/e' (r = -0.46, P = 0.003) and s' (r = 0.36, P = 0.02), but not with LVEF (r = 0.18, P = 0.26). When adjusting for CFR in a multivariable linear model, s' but not E/e' remained independently associated with VO2 peak.
In this group of heart failure patients, VO2 peak was correlated with CFR, E/e', and s' but not with traditional measures of systolic function. CFR remained associated with VO2 peak independently of diastolic and systolic function and is likely to be a limiting factor in functional capacity of heart failure patients.</abstract><cop>England</cop><pmid>23169759</pmid><doi>10.1093/ehjci/jes269</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Aged Body Composition Chi-Square Distribution Coronary Circulation - physiology Diastole - physiology Echocardiography, Doppler, Color - methods Echocardiography, Doppler, Pulsed - methods Exercise - physiology Exercise Test - methods Exercise Tolerance - physiology Female Fractional Flow Reserve, Myocardial Heart Failure, Systolic - diagnosis Heart Failure, Systolic - therapy Humans Linear Models Male Middle Aged Multivariate Analysis Oxygen Consumption - physiology Prognosis Pulse Wave Analysis Severity of Illness Index Statistics, Nonparametric Stroke Volume Systole - physiology |
| title | Coronary flow reserve as a link between diastolic and systolic function and exercise capacity in heart failure |
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