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

Fingerprint

Cardiomyopathies
Blood Vessels
Exercise
Blood Pressure
Pulse
Heart Rate
Cytidine Monophosphate
Exercise Tolerance
Oxygen Consumption
Stroke Volume
Echocardiography
Magnetic Resonance Spectroscopy
Multivariate Analysis
Heart Failure
Population

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

Cite this

Relation of ventricular-vascular coupling to exercise capacity in ischemic cardiomyopathy : A cardiac multi-modality imaging study. / Wong, Raymond C.; Dumont, Carlos A.; Austin, Bethany A.; Kwon, Deborah H.; Flamm, Scott D.; Thomas, James D.; Starling, Randall C.; Desai, Milind Y.

In: International Journal of Cardiovascular Imaging, Vol. 26, No. 2, 02.2010, p. 151-159.

Research output: Contribution to journalArticle

Wong, Raymond C. ; Dumont, Carlos A. ; Austin, Bethany A. ; Kwon, Deborah H. ; Flamm, Scott D. ; Thomas, James D. ; Starling, Randall C. ; Desai, Milind Y. / Relation of ventricular-vascular coupling to exercise capacity in ischemic cardiomyopathy : A cardiac multi-modality imaging study. In: International Journal of Cardiovascular Imaging. 2010 ; Vol. 26, No. 2. pp. 151-159.
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