Left ventricular systolic and diastolic function, and exercise capacity six to eight weeks after acute myocardial infarction

Lewis, Basil S.; Emmott, Steven N.; Smyllie, John H.; MacNeill, Andrea B.; Lubsen, Jacobus

doi:10.1016/0002-9149(93)90151-2

Cited by 28 publications

(8 citation statements)

References 25 publications

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“…We have previously dis cussed the mechanisms by which captopril could prevent the development of diastolic dysfunction in post-MI patients [10]; these include prevention of LV dilatation with sub sequent changes in compliance as well as reduction in myocardial ischemia. Lewis et al [5] have previously described an inverse rela tion between peak exercise work load and PA measured in the mitral annulus, whereas they, as in the present study, were unable to demon strate any relation when PA was measured between the mitral leaflets. However, we found an inverse relation between percentage changes in PA and percentage changes in exercise capacity.…”

Section: Discussioncontrasting

confidence: 83%

“…Thus, interpretation of the transmitral flow as index of diastolic function should be done cautiously. Since we included patients in whom spontaneous ST segment depressions occurred frequently during daily life activity [8] abnormalities of diastolic function would be amplified [28,29], Low exercise responses have been demon strated in conditions with abnormal diastolic function [3][4][5], We are able to confirm this as demonstrated by the significantly lower exer cise capacity among patients with abnormal transmitral flow. In addition, deterioration in exercise capacity throughout the trial period was restricted to the placebo group.…”

Section: Discussionmentioning

confidence: 91%

“…Thus, conditions which interfere with ventricular relaxation and filling may reduce exercise ca pacity and limited exercise capacity has been reported in the presence of abnormal diastolic function [3,4], Furthermore, maximal work load achieved during exercise is dependent on the peak velocity of the late filling phase of the transmitral flow as evaluated by Doppler echocardiography [5], Long-term treatment with an angiotensin converting enzyme (ACE) inhibitor of pa tients with congestive heart failure or recent MI may improve exercise capacity [6][7][8]. In addition, ACE inhibition has proven to be beneficial in respect of improving LV systolic function and preventing diastolic dysfunction [9,10].…”

Section: Introductionmentioning

confidence: 99%

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Exercise Capacity in Patients with Left Ventricular Dysfunction following Acute Myocardial Infarction: Relation to Systolic and Diastolic Function and Intervention with Captopril

Søgaard

Gøtzsche²,

Ravkilde³

et al. 1994

Cardiology

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Patients with acute or chronic heart disease may have limited exercise capacity if they have reduced left ventricular function. Indexes of reduced left ventriuclar function during exercise are a predictor of subsequent survival although left ventricular ejection fraction is a poor predictor of physical endurance. We evaluated the effect of captopril on physical endurance in 48 males with left ventricular dysfunction following myocardial infarction. On the 7th day following myocardial infarction patients were randomized to either captopril 50 mg daily or corresponding placebo. Patients were followed up by means of serial echocardiography and exercise stress testing for a period of 180 days. Exercise capacity was significantly improved in the captopril group. Changes in exercise capacity were significantly correlated to changes in left ventricular (LV) volumes and compliance. The beneficial effect of captopril on exercise capacity was probably mediated via improvement in LV performance and compliance.

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Section: Discussioncontrasting

confidence: 83%

Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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Exercise Capacity in Patients with Left Ventricular Dysfunction following Acute Myocardial Infarction: Relation to Systolic and Diastolic Function and Intervention with Captopril

Søgaard

Gøtzsche²,

Ravkilde³

et al. 1994

Cardiology

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“…The poor relationship between EF and maximum exercise workload in previous studies [1,2,4] was confirmed in the present investigation and reflects the complex interplay between the multiple factors that determine exercise capacity. EF evaluates only globally systolic function and provides no insight into the role of regional wall motion abnormalities or of LV diastolic dysfunction.…”

Section: Discussionsupporting

confidence: 74%

“…In contrast, estimates of diastolic function have been associated with exercise capacity in some studies of selected patients [3,4]. In these studies, patients with residual ischemia after myocardial infarction have been excluded, and patients with a large age range have been included.…”

Section: Introductionmentioning

confidence: 99%

Diastolic and Systolic Function as Predictors of Exercise Capacity after Myocardial Infarction in Young Men

Eriksson

Caidahl²,

Fairé³

et al. 1998

Cardiology

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We evaluated the power of measurements of left ventricular (LV) systolic and diastolic function for predicting exercise capacity in 97 young male survivors of a myocardial infarction. The patients were evaluated with M-mode echocardiography, a symptom-limited exercise test and coronary and LV angiography. In univariate analyses, maximum exercise workload was most closely related to the atrial emptying index, an index of diastolic function (r = 0.37, p < 0.005), but not to LV ejection fraction (r = 0.001, NS). This relationship was stronger in the 42 patients without signs of ischemia during exercise (r = 0.51, p < 0.005). Multivariate analyses indicated that the atrial emptying index (p < 0.005) provided independent contribution to the prediction of maximum exercise capacity. LV diastolic function but not LV systolic function was related to exercise capacity in young survivors of myocardial infarction.

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Acute changes in left ventricular diastolic function: Cigarette smoking versus nicotine gum

et al. 2006

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SummaryBackground: Echocardiographic evidence of diastolic dysfunction has been demonstrated during acute cigarette smoking in patients with coronary artery disease. Similar studies in healthy patients have shown conflicting results. Furthermore, it is unclear whether nicotine or some other cigarette-related substance is responsible for these observations.Hypothesis: The purpose of the study was to confirm or refute acute effects of cigarette smoking on diastolic function in healthy patients and to compare diastolic effects of a cigarette to smokeless nicotine delivery (nicotine gum).Methods: In all, 27 healthy volunteers were self-assigned into one of two cohorts. A baseline echocardiogram was performed in all patients. The first cohort proceeded to smoke a cigarette and the second to chew a piece of nicotine gum. Within minutes after exposure, another echocardiogram was performed. Traditional measures of diastolic function were compared before and after substance exposure by paired t-tests.Results: The cigarette cohort showed echocardiographic evidence of diastolic dysfunction after smoking. The E:A ratio (time integral) decreased from 2.95 to 2.22 (p < 0.002). Atrial reversal pulmonary velocity, atrial reversal duration, and color flow propagation all showed statistically significant alterations (p < 0.05). The nicotine gum cohort showed no change in traditional diastolic parameters.

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Left ventricular systolic and diastolic function, and exercise capacity six to eight weeks after acute myocardial infarction

Cited by 28 publications

References 25 publications

Exercise Capacity in Patients with Left Ventricular Dysfunction following Acute Myocardial Infarction: Relation to Systolic and Diastolic Function and Intervention with Captopril

Exercise Capacity in Patients with Left Ventricular Dysfunction following Acute Myocardial Infarction: Relation to Systolic and Diastolic Function and Intervention with Captopril

Diastolic and Systolic Function as Predictors of Exercise Capacity after Myocardial Infarction in Young Men

Acute changes in left ventricular diastolic function: Cigarette smoking versus nicotine gum

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