Stratification of impaired relaxation filling patterns by passive leg lifting in patients with preserved left ventricular ejection fraction.
Eur J Heart Fail
; 10(11): 1094-101, 2008 Nov.
Article
in En
| MEDLINE
| ID: mdl-18755627
ABSTRACT
METHODS:
We evaluated diastolic functional reserve in 108 patients with normal left ventricular ejection fraction (LVEF)> or =50% but abnormal relaxation (ratio of transmitral peak velocity of early and late diastolic flow (E/A)<1) using passive leg lifting. We calculated the pulmonary venous systolic to diastolic flow ratio (S/D) as a marker of left atrial reservoir function, and the time difference between the duration of pulmonary venous retrograde flow (PVAd) and the duration of the mitral A wave (PVAd-Ad) as a marker of left ventricular end-diastolic pressure (LVEDP).RESULTS:
During leg lifting, the E/A was > or =1 in 39 patients (the inverted group); the remaining 69 patients comprised the stable group. Comparing the inverted group with the stable group at baseline, S/D was smaller (1.5+/-0.4 vs. 1.8+/-0.5, P=0.002) and PVAd-Ad greater (11+/-23 ms vs. -23+/-28 ms, P<0.001). Multiple logistic regression analysis revealed that PVAd-Ad and S/D predicted E/A inversion with leg lifting after adjustment for age, LV wall thickness, LV dimension, LVEF, deceleration time of E, and E/E'.CONCLUSION:
In patients with preserved LVEF but early diastolic dysfunction, passive leg lifting may identify patients having a less compliant left ventricle and impaired left atrial reservoir function.
Full text:
1
Database:
MEDLINE
Main subject:
Stroke Volume
/
Exercise
/
Ventricular Dysfunction, Left
/
Exercise Test
/
Leg
/
Myocardial Contraction
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Eur J Heart Fail
Journal subject:
CARDIOLOGIA
Year:
2008
Type:
Article
Affiliation country:
Japan