Clinical assessment and follow-up of functional capacity in patients with chronic congestive cardiomyopathy

Engler, Robert L.; Ray, Ramdip; Higgins, Charles B.; McNally, Catherine; Buxton, Wendy Hansen; Bhargava, Valmik; Shabetai, Ralph

doi:10.1016/0002-9149(82)90199-0

Cited by 90 publications

(18 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, our understanding of the role of the right ventricle in the maintenance of normal cardiac function has changed dramatically. It has been shown that right ventricular function is a major determinant of cardiac symptoms and exercise capacity in chronic heart failure' 4 ' 51 . An increase in pulmonary wedge pressure as a result of mitral or aortic valve disease is associated with a rise in mean pulmonary artery pressure.…”

Section: Introductionmentioning

confidence: 99%

Importance of the right ventricle in valvular heart disease

Nagel¹,

Stuber²,

Hess³

1996

European Heart Journal

106

View full text Add to dashboard Cite

The importance of the right ventricle as a determinant of clinical symptoms, exercise capacity, peri-operative survival and postoperative outcome has been underestimated for a long time. Right ventricular ejection fraction has been used as a measure of right ventricular function but has been found to be dependent on loading conditions, ventricular interaction as well as on myocardial structure. Altered left ventricular function in patients with valvular disease influences right ventricular performance mainly by changes in afterload but also by ventricular interaction. Right ventricular function and regional wall motion can be determined with right ventricular angiography, radionuclide ventriculography, two-dimensional echocardiography or magnetic resonance imaging. However, the complex structure of the right ventricle and its pronounced translational movements render quantification difficult. True regional wall motion analysis is, however, possible with myocardial tagging based on magnetic resonance techniques. With this technique a baso-apical shear motion of the right ventricle was observed which was enhanced in patients with aortic stenosis. (Eur Heart J 1996; 17: [829][830][831][832][833][834][835][836]

show abstract

Section: Introductionmentioning

confidence: 99%

Importance of the right ventricle in valvular heart disease

Nagel¹,

Stuber²,

Hess³

1996

European Heart Journal

106

View full text Add to dashboard Cite

show abstract

“…For example, LV ejection fraction, a measurement obtained at rest, does not predict functional capacity measured by maximal oxygen consumption or treadmill time. 11 In the present study, we found differences in the 2 groups in terms of inotropic reserve, estimated by infused isoproterenol and NKH447, and in echocardiographic assessment of LV function during dobutamine stress. In addition, there were also changes in static measures of LV geometry and reduced plasma concentrations of BNP, indicating improved global LV function.…”

Section: Discussionmentioning

confidence: 41%

Intracoronary Adenovirus Encoding Adenylyl Cyclase VI Increases Left Ventricular Function in Heart Failure

et al. 2004

View full text Add to dashboard Cite

Background-We tested the hypothesis that intracoronary delivery of an adenovirus encoding adenylyl cyclase type VI (Ad.AC VI ) would be associated with increased left ventricular (LV) function in pigs with congestive heart failure. Methods and Results-Pigs (52Ϯ6 kg; nϭ16) underwent placement of pacemakers, LV pressure transducers, and left atrial and aortic catheters. Physiological and echocardiographic studies were obtained from conscious animals 13 days later, and pacing was initiated (220 bpm). Seven days later, measures of LV function were reduced, documenting severe LV dysfunction and dilation. Pigs then received intracoronary Ad.AC VI (1.4ϫ10 12 vp; nϭ7) or saline (PBS; nϭ9) (randomized, blinded), with concomitant infusion of nitroprusside (50 g/min, 6.4 minutes) to increase gene transfer. Pacing was continued for 14 days, and final studies were obtained. The a priori key end point was change in LV dP/dt during isoproterenol infusion (pre-Ad.AC VI value minus value after 21 days of pacing). Pigs receiving Ad.AC VI showed a smaller decrease in both LV ϩdP/dt (Pϭ0.0014) and LV ϪdP/dt (Pϭ0.0008). Serial echocardiography showed that Ad.AC VI treatment was associated with increased LV function and reduced LV dilation and that end-systolic wall stress was reduced. AC-stimulated cAMP production was increased 1.7-fold in LV samples from Ad.AC VI -treated pigs (Pϭ0.006), and B-type natriuretic peptide was reduced (0.035). Gene transfer was confirmed by polymerase chain reaction. Conclusions-AC

show abstract

“…The mean value of NP, liver size, BP, pulse pressure, CT Ratio, LVID (in diastole), LVEF between initial and end of follow up do not show significant change except for improvement in heart rate (P< 0.05). There was no correlation between changes in exercise capacity and changes in ejection fraction, EPSS, CT Ratio, Pulmonary venous congestion or systolic time intervals [3]. Other studies have also shown that physical findings, Xray chest, echocardiogram and resting haemodynamics are inconsistently altered by therapeutic interventions which do increase exercise capacity [10].…”

Section: Discussionmentioning

confidence: 91%

Quantification of Exercise Tolerance in Congestive Heart Failure and Role of Ace Inhibitors

Hasija

Karloopia

Shahi

et al. 1998

Medical Journal Armed Forces India

View full text Add to dashboard Cite

A prospective randomised controlled trial with captopril/enalapril was carried out on 25 patients with congestive heart failure (CHF) of various aetiologies in NYHA Class II & III to study the effect of Ace inhibitors on exercise tolerance. The control group (Gp-A) comprising of 12 patients received conventional treatment (digitalis and diuretics) and the test group (Gp-B) with 13 patients were in addition given captopril/enalapril as tolerated. They were followed up for a mean period of 101.6+50.6 days (approx 3 months). Ten patients from each group could complete the study. The exercise testing was done on treadmill using a suitable protocol and end-points, at the beginning and end of study. None of the clinical and noninvasive parameters showed significant difference, however the mean exercise duration in Group A improved from 7.84+3.34 to 9.2 +3.16 minute (P <0.05) and in Group B increased from 7.91+4.6 to 10. 92+4.66 minute (p < 0.001). On comparing the benefits of the two groups the difference was statistically significant (P < 0.05).lt is concluded that Ace inhibitor improves the exercise tolerance in CHF and the benefit is evident despite any improvement in clinical and noninvasive indices of left ventricular function. MJAFI 1998; 54: 331-334

show abstract

Clinical assessment and follow-up of functional capacity in patients with chronic congestive cardiomyopathy

Cited by 90 publications

References 11 publications

Importance of the right ventricle in valvular heart disease

Importance of the right ventricle in valvular heart disease

Intracoronary Adenovirus Encoding Adenylyl Cyclase VI Increases Left Ventricular Function in Heart Failure

Quantification of Exercise Tolerance in Congestive Heart Failure and Role of Ace Inhibitors

Contact Info

Product

Resources

About