Relation of ventricular-vascular coupling to exercise capacity in ischemic cardiomyopathy: A cardiac multi-modality imaging study

Raymond C. Wong, Carlos A. Dumont, Bethany A. Austin, Deborah H. Kwon, Scott D. Flamm, James D. Thomas, Randall C. Starling, Milind Y. Desai

Research output: Contribution to journalArticle

Abstract

The purpose of this study was to examine the relationship between noninvasive measurements of ventricular-vascular coupling (VVC) with exercise tolerance, and compared the value of VVC versus other traditional determinants of exercise capacity in this population. 43 patients with ischemic CMP (age 59 ± 9 years, mean EF 24 ± 8%) underwent cardiopulmonary exercise testing, echocardiography and cardiac magnetic resonance (CMR). VVC was defined non-invasively by the ratio of ventricular systolic elastance (Ees) to the arterial elastance (Ea), where Ees = end-systolic pressure/end-systolic volume index and Ea = end-systolic pressure/stroke volume index. VVC significantly correlated with baseline heart rate (HR), peak exercise systolic blood pressure, maximum oxygen consumption (MVO2) and peak O2 pulse (MVO2/HR). A higher VVC was associated with higher LVEF and RVEF but showed inverse relation to mitral E wave velocity. Univariate predictors of MVO2 are baseline HR, chronotropic reserve, VVC and aortic distensibility; whilst mitral E wave velocity, LVEF, VVC, Ees significantly correlated with peak O2 pulse. By stepwise multivariate analysis, VVC remained the only independent predictor of peak O2 pulse. Ventricular-vascular coupling at rest may be a clinically important parameter in predicting exercise capacity in patients with advanced heart failure, and may become an additional target for therapeutic interventions.

Original languageEnglish (US)
Pages (from-to)151-159
Number of pages9
JournalInternational Journal of Cardiovascular Imaging
Volume26
Issue number2
DOIs
StatePublished - Feb 2010
Externally publishedYes

Keywords

  • Echocardiography
  • Ischemic cardiomyopathy
  • Magnetic resonance imaging
  • Metabolic exercise stress test
  • Ventricular-vascular coupling

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Wong, R. C., Dumont, C. A., Austin, B. A., Kwon, D. H., Flamm, S. D., Thomas, J. D., Starling, R. C., & Desai, M. Y. (2010). Relation of ventricular-vascular coupling to exercise capacity in ischemic cardiomyopathy: A cardiac multi-modality imaging study. International Journal of Cardiovascular Imaging, 26(2), 151-159. https://doi.org/10.1007/s10554-009-9516-4