Left ventricular diastolic function and cardiac performance during exercise in patients with acromegaly(433 views) Spinelli L, Petretta M, Verderame G, Carbone G, Venetucci AA, Petretta A, Acampa W, Bonaduce D, Colao A, Cuocolo A
Department of Internal Medicine, Federico II University, 80131 Naples, Italy
Dept. Biomorphological/Funct. Sci., Federico II University, 80131 Naples, Italy
Dept. Molec./Clinic. Endocrinol./O., Inst. Biostructures/Bioimages N., Federico II University, 80131 Naples, Italy
Sci. Inst. for Res./Care Neuromed, 86077 Pozzilli, Italy
Dept. Molec. /Clinic. Endocrinol. /O., Inst. Biostructures/Bioimages N., Federico II University, 80131 Naples, Italy
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Sacc, L., Cittadini, A., Fazio, S., Growth hormone and the heart (1994) Endocr Rev, 15, pp. 555-573
Vanoverschelde, J. J., Essamri, B., Vanbutsele, R., D'Hondt, A., Cosyns, J. R., Detry, J. R., Melin, J. A., Contribution of left ventricular diastolic function to exercise capacity in normal subjects (1993) J Appl Physiol, 74, pp. 2225-2233
Nishimura, R. A., Appleton, C. P., Redfield, M. M., Ilstrup, D. M., Holmes, D. R., Tajik, J., Non-invasive Doppler echocardiographic evaluation of left ventricular filling pressures in patients with cardiomyopathies: A simultaneous Doppler echocardiographic and cardiac catheterization study (1996) J Am Coll Cardiol, 28, pp. 1226-1233
Appleton, C. P., Galloway, J. M., Gonzales, M. S., Gaballa, M., Basnight, M. A., Estimation of left ventricular filling pressures using two-dimensional and Doppler echocardiography in adult patients with cardiac disease. Additional value of analyzing left atrial size, left atrial ejection fraction and the difference in duration of pulmonary venous and mitral flow velocity at atrial contraction (1993) J Am Coll Cardiol, 22, pp. 1972-1982
Bacharach, S. L., Green, M. V., Borer, J. S., Hyde, J. E., Farkas, S. P., Johnston, G. S., Left ventricular peak ejection rate, filling rate and ejection fraction: Frame requirements at rest and exercise (1979) J Nucl Med, 20, pp. 1889-1893
Bonow, R. O., Bacharach, S. L., Green, M. V., Impaired left ventricular diastolic filling in patients with coronary artery disease: Assessment with radionuclide angiography (1981) Circulation, 64, pp. 315-323
Bonow, R. O., Vitale, D. F., Bacharach, S. L., Frederick, T. M., Kent, K. M., Green, M. V., Asynchronous left ventricular regional function and impaired global diastolic filling in patients with coronary artery disease: Reversal after coronary angioplasty (1985) Circulation, 71, pp. 297-307
Sahn, D. H., DeMaria, A., Kisslo, J., Weyman, A., The Committee on M-Mode Standardization of the American Society of Echocardiography: Recommendations regarding quantitation in M-mode echocardiography. Results of a survey of echocardiographic measurements (1978) Circulation, 58, pp. 1071-1108
Devereux, R. B., Reichek, N., Echocardiographic determination of left ventricular mass in man: Anatomic validation of method (1977) Circulation, 56, pp. 613-618
Jones, R. H., McEwan, P., Newman, G. E., Port, S., Rerych, S. K., Scholz, P. M., Upton, M. T., Sabiston D. C., Jr., Accuracy of diagnosis of coronary artery disease by radionuclide management of left ventricular function during rest and exercise (1981) Circulation, 64, pp. 586-601
Kitzman, D. W., Higginbotham, M. B., Cobb, F. R., Sheikh, K. H., Sullivan, M. J., Exercise intolerance in patients with heart failure and preserved left ventricular systolic function: Failure of the Frank-Starling mechanism (1991) J Am Coll Cardiol, 17, pp. 1065-1072
Dougherty, A. H., Naccarelli, G. V., Gray, E. L., Hicks, C. H., Goldstein, R. A., Congestive heart failure with normal systolic function (1984) Am J Cardiol, 54, pp. 778-782
Hunter, J. J., Chien, K. R., Signaling pathways for cardiac hypertrophy and failure (1999) N Engl J Med, 341, pp. 1276-1283
Hayward, R. P., Emanuel, R. W., Nabarro, J. D., Acromegalic heart disease: Influence of treatment of the acromegaly on the heart (1987) Q J Med, 62, pp. 41-58
Lie, J. T., Grossman, S. J., Pathology of the heart in acromegaly: Anatomic findings in 27 autopsied patients (1980) Am Heart J, 100, pp. 41-52
Left ventricular diastolic function and cardiac performance during exercise in patients with acromegaly
Exercise-induced impairment of left ventricular (LV) ejection fraction is common in patients with acromegaly and normal resting systolic function. This study aimed to clarify whether diastolic dysfunction plays a role in the abnormal adaptation to exercise in these patients. Forty-eight patients with active acromegaly underwent LV radionuclide angiography at rest and during exercise. Doppler echocardiography was also performed to assess LV mass index and diastolic function by combined analysis of mitral and pulmonary flow velocity curves. LV ejection fraction at peak exercise was related to rest ejection fraction (r = 0.78; P < 0.001), peak filling rate (r = 0.55; P < 0.01), LV mass index (r = -0.56; P < 0.001), and the difference between duration of diastolic reverse pulmonary vein flow and mitral flow at atrial contraction (A duration) (r = -0.54; P < 0.01). At stepwise regression analysis, rest ejection fraction and A duration were the only variables that independently influenced (P < 0.001) ejection fraction at peak exercise. Diastolic dysfunction is important in determining cardiac performance during exercise in patients with acromegaly and normal resting systolic function. Combined analysis of pulmonary vein and mitral flow velocity curves allows the identification of impaired LV diastolic function in such patients.
Left ventricular diastolic function and cardiac performance during exercise in patients with acromegaly
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