Publication: Left atrial volume as an independent predictor of exercise capacity in patients with isolated diastolic dysfunction presented with exertional dyspnea
1
Issued Date
2014
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eng
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Mahidol University
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BioMed Central
Bibliographic Citation
Cardiovascular Ultrasound. Vol. 12, (2014), 19
Suggested Citation
Nithima Ratanasit, Khemajira Karaketklang, Srisakul Chirakarnjanakorn, Rungroj Krittayaphong, Decho Jakrapanichakul Left atrial volume as an independent predictor of exercise capacity in patients with isolated diastolic dysfunction presented with exertional dyspnea. Cardiovascular Ultrasound. Vol. 12, (2014), 19. doi:10.1186/1476-7120-12-19 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/2663
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Title
Left atrial volume as an independent predictor of exercise capacity in patients with isolated diastolic dysfunction presented with exertional dyspnea
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Abstract
Background: Left atrial volume (LAV) and exercise capacity are important prognostic determinants of
cardiovascular risk. Exercise intolerance and increased LAV are expected in patients with diastolic dysfunction. While
dyspnea is the symptom reported by the patient and considered subjective, exercise capacity obtained by exercise
testing provides an objective measure of cardiovascular fitness. The objective of this study is to determine the
relationship between LAV index and exercise capacity in patients with isolated diastolic dysfunction who presented
with exertional dyspnea.
Methods: We studied consecutive patients with dyspnea who underwent treadmill exercise testing and
transthoracic echocardiography on the same day. LAV was assessed using the biplane area-length method.
Symptom-limited exercise testing was performed immediately after echocardiography. Patients with coronary artery
disease, valvular or congenital heart disease, left ventricular systolic dysfunction, pulmonary hypertension or positive
exercise test were excluded.
Results: The study consisted of 111 patients (58.1 ± 9.2 years of age, 54.1% male, 64% hypertension, 57.7%
dyslipidemia and 20.7% diabetes). The exercise duration and capacity were 6.8 ± 2.1 minutes and 7.7 ± 1.9 METs,
respectively. Left ventricular ejection fraction and LAV index was 71.0 ± 5.8% and 31.4 ± 10.5 ml/m2, respectively. In
multivariate analysis, age [odds ratios (OR) 0.94; 95% confidence interval (CI) 0.89-0.99], body mass index (OR 0.82,
95% CI 0.72-0.93), and LAV index (OR 0.92, 95% CI 0.87-0.97) were associated with good exercise capacity.
Conclusion: In patients with isolated diastolic dysfunction and exertional dyspnea, an increased LAV index, a
marker of chronic diastolic dysfunction, is associated with poor exercise capacity.