학술논문
Hemodynamic Heterogeneity of Reduced Cardiac Reserve Unmasked by Volumetric Exercise Echocardiography
Document Type
article
Author
Tonino Bombardini; Angela Zagatina; Quirino Ciampi; Rosina Arbucci; Pablo Martin Merlo; Diego M. Lowenstein Haber; Doralisa Morrone; Antonello D'Andrea; Ana Djordjevic-Dikic; Branko Beleslin; Milorad Tesic; Nikola Boskovic; Vojislav Giga; José Luis de Castro e Silva Pretto; Clarissa Borguezan Daros; Miguel Amor; Hugo Mosto; Michael Salamè; Ines Monte; Rodolfo Citro; Iana Simova; Martina Samardjieva; Karina Wierzbowska-Drabik; Jaroslaw D. Kasprzak; Nicola Gaibazzi; Lauro Cortigiani; Maria Chiara Scali; Mauro Pepi; Francesco Antonini-Canterin; Marco A. R. Torres; Michele De Nes; Miodrag Ostojic; Clara Carpeggiani; Tamara Kovačević-Preradović; Jorge Lowenstein; Adelaide M. Arruda-Olson; Patricia A. Pellikka; Eugenio Picano; on behalf of the Stress Echo 2020 Study Group of the Italian Society of Cardiovascular Imaging
Source
Journal of Clinical Medicine, Vol 10, Iss 13, p 2906 (2021)
Subject
Language
English
ISSN
2077-0383
Abstract
Background: Two-dimensional volumetric exercise stress echocardiography (ESE) provides an integrated view of left ventricular (LV) preload reserve through end-diastolic volume (EDV) and LV contractile reserve (LVCR) through end-systolic volume (ESV) changes. Purpose: To assess the dependence of cardiac reserve upon LVCR, EDV, and heart rate (HR) during ESE. Methods: We prospectively performed semi-supine bicycle or treadmill ESE in 1344 patients (age 59.8 ± 11.4 years; ejection fraction = 63 ± 8%) referred for known or suspected coronary artery disease. All patients had negative ESE by wall motion criteria. EDV and ESV were measured by biplane Simpson rule with 2-dimensional echocardiography. Cardiac index reserve was identified by peak-rest value. LVCR was the stress-rest ratio of force (systolic blood pressure by cuff sphygmomanometer/ESV, abnormal values ≤2.0). Preload reserve was defined by an increase in EDV. Cardiac index was calculated as stroke volume index * HR (by EKG). HR reserve (stress/rest ratio)