Pace L, Nappi A, Imbriaco M, Cuocolo A, Varrone A, Romano M, Trimarco B, Salvatore M
Università Federico II, Centro CNR Medicina Nucleare, Napoli.
Radiol Med. 2000 Sep;100(3):120-5.
To evaluate the relationship of systolic and diastolic function at rest to exercise capacity.
Seventeen patients with ischemic heart failure were included in the study. Ambulatory left ventricular monitoring at rest and during upright exercise with combined analysis of pulmonary gas exchange was performed. Ejection fraction, end-diastolic volume, end-systolic volume, stroke volume, cardiac output, and peak filling rate were measured.
Significant positive correlations were found between rest ejection fraction and peak oxygen consumption (r = .60, p < .01), peak cardiac output (r = .77, p < .0001), peak stroke volume (r = .67, p < .005), and peak ejection fraction (r = .69, p < .005). On the other hand, peak filling rate at rest showed a significant inverse correlation with peak end-diastolic (r = -.48, p < .05) and end-systolic (r = -.66, p < .005) volumes. The patients were then subgrouped into two groups according to their rest ejection fraction (lower or higher than 40%). In the group with ejection fraction less than 40% a significant correlation was observed between rest ejection fraction and both peak stroke volume (r = .66, p < .05) and peak ejection fraction (r = .69, p < .05). In the same group of patients an inverse correlation was found between peak filling rate and both end-diastolic (r = -0.65, p < .05) and end-systolic (r = -.82, p < .005) volumes.
The results of the present study suggest that exercise capacity is related to left ventricular function at rest and that rest diastolic function might be a determinant of left ventricular function during exercise in patients with heart failure.
评估静息状态下的收缩和舒张功能与运动能力之间的关系。
本研究纳入了17例缺血性心力衰竭患者。进行静息和直立运动时的动态左心室监测,并结合肺气体交换分析。测量射血分数、舒张末期容积、收缩末期容积、每搏量、心输出量和峰值充盈率。
静息射血分数与峰值耗氧量(r = 0.60,p < 0.01)、峰值心输出量(r = 0.77,p < 0.0001)、峰值每搏量(r = 0.67,p < 0.005)和峰值射血分数(r = 0.69,p < 0.005)之间存在显著正相关。另一方面,静息峰值充盈率与峰值舒张末期(r = -0.48,p < 0.05)和收缩末期(r = -0.66,p < 0.005)容积呈显著负相关。然后根据静息射血分数(低于或高于40%)将患者分为两组。在射血分数低于40%的组中,静息射血分数与峰值每搏量(r = 0.66,p < 0.05)和峰值射血分数(r = 0.69,p < 0.05)之间均观察到显著相关性。在同一组患者中,峰值充盈率与舒张末期(r = -0.65,p < 0.05)和收缩末期(r = -0.82,p < 0.005)容积均呈负相关。
本研究结果表明,运动能力与静息状态下的左心室功能有关,并且静息舒张功能可能是心力衰竭患者运动期间左心室功能的一个决定因素。