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      Diastolic and Systolic Function as Predictors of Exercise Capacity after Myocardial Infarction in Young Men

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          We evaluated the power of measurements of left ventricular (LV) systolic and diastolic function for predicting exercise capacity in 97 young male survivors of a myocardial infarction. The patients were evaluated with M-mode echocardiography, a symptom-limited exercise test and coronary and LV angiography. In univariate analyses, maximum exercise workload was most closely related to the atrial emptying index, an index of diastolic function (r = 0.37, p < 0.005), but not to LV ejection fraction (r = 0.001, NS). This relationship was stronger in the 42 patients without signs of ischemia during exercise (r = 0.51, p < 0.005). Multivariate analyses indicated that the atrial emptying index (p < 0.005) provided independent contribution to the prediction of maximum exercise capacity. LV diastolic function but not LV systolic function was related to exercise capacity in young survivors of myocardial infarction.

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          Lack of correlation between exercise capacity and indexes of resting left ventricular performance in heart failure

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            Echocardiographic diastolic ventricular abnormality in hypertensive heart disease: atrial emptying index.

            To analyze changes in left ventricular diastolic properties in hypertensive heart disease, the atrial emptying index was used to assess the rapid phase of diastolic filling of the left ventricle. Ten normal subjects (Group 1), 11 hypertensive patients without evidence of cardiac involvement (Group 2) and 10 hypertensive patients with echocardiographic evidence of left ventricular hypertrophy (Group 3) were compared using M mode echocardiography and systemic hemodynamic data. Whereas cardiac index (dye-dilution method) and rate of circumferential fiber shortening (echocardiogram) were normal in all three groups, there was a progressive increase in left atrial index (p less than 0.001, Group 1 versus Group 2 and versus Group 3) and a progressive decrease in the atrial emptying index (p less than 0.001, Group 1 versus Group 2 and versus Group 3). No correlation existed between the atrial emptying index and the left atrial index, mean arterial pressure or total peripheral resistance in any of the three groups. These data suggest that rapid filling of the left ventricle is reduced early in hypertension, even before electrocardiographic or systolic echocardiographic abnormalities are detectable. The atrial emptying index therefore appears to be an early indicator of abnormalities of left ventricular diastolic compliance in uncomplicated hypertension.

              Author and article information

              S. Karger AG
              July 1998
              14 August 1998
              : 90
              : 1
              : 8-12
              a Department of Medicine, Danderyd Hospital, Danderyd, b Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, c Department of Medicine, King Gustav V Research Institute, Karolinska Hospital, Stockholm, d Division of Medicine, Huddinge Hospital, Huddinge, Sweden
              6809 Cardiology 1998;90:8–12
              © 1998 S. Karger AG, Basel

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              Page count
              Pages: 5
              General Cardiology


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