Diastolic stress echocardiography: A novel noninvasive diagnostic test for diastolic dysfunction using supine bicycle exercise Doppler echocardiography
Section snippets
Study population
We studied patients who were referred to the stress echocardiography laboratory for evaluation of exertional dyspnea. Patients with a LV ejection fraction (EF) < 50%, atrial or ventricular arrhythmia, valvular disease (of moderate or greater severity), evidence of coronary artery disease by coronary angiography or stress test, and a history of myocardial infarction were excluded. This study was approved by our institutional review board.
Two-dimensional and Doppler echocardiography (diastolic stress echocardiography)
Standard 2-dimensional measurements (LV diastolic and
Patients
A total of 53 patients were enrolled. None had echocardiographic or electrocardiographic evidence of myocardial ischemia. One patient was excluded because of severe hypertension at rest and another because of poor image quality. Tachycardia (sinus tachycardia in 5 patients, atrial fibrillation in 1) during a low level of exercise made the LV filling pattern uninterpretable in 6 patients. The other 45 patients (19 men) were included in the study. The mean age was 59 ± 16 years (range 20-83
Discussion
The principal goal of this investigation was to introduce a novel noninvasive diagnostic test to detect an exercise-induced increase in diastolic filling pressures using supine bicycle Doppler echocardiography. The preliminary results showed that diastolic stress echocardiography using supine bicycle exercise is technically feasible for demonstrating the change in E/E′ (ie, filling pressure) with exercise and that the hemodynamic consequences of exercise-induced increase in diastolic filling
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Supported by postdoctoral fellowship grant 0120622Z from the American Heart Association, Northland Affiliate (Dr Ha).