Pulsed Doppler for the Evaluation of Effort Intolerance in Left Ventricle Diastolic Dysfunction in Dilated Cardiomyopathy

pp 395-402

Abstract

Background

Effort intolerance in heart failure is multifactorial in origin. Left ventricular ejection fraction correlates weakly with measures of exercise intolerance.

Material and method

In patients with heart failure and dilated cardiomyopathy we evaluate functional capacity by NewYork Heart Association class, Naught on test and six minutes walk test and we evaluate eco-Doppler parameters of left ventricular systolic (ejection fraction) and diastolic function (pulsed Doppler mitral filling pattern). We analized univariate and multi-variate correlates.

Results

We include 58 patients, mean age 58 ± 12 years, 46 men (79%). Naughton test correlates moderately with six minutes walk (r=0.64). Left ventricular ejection fraction correlates weakly with both measures of exercise intolerance. "E" wave deceleration time in mitral filling pattern significantly correlates (r = 0.37) with Naught on test and six minutes walk (r=0.31). By multivariate analysis "E" wave deceleration time was the unique determinant of both measures of effort intolerance.

Conclusions

Our results suggest that diastolic dysfunction intervenes more than systolic dysfunction in the genesis of symptoms in dilated cardiomyopathy.