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ID 114204
Title Alternative
RV Function in Cardiac Rehabilitation
Author
Seno, Hiromitsu Tokushima University
Nishio, Susumu Tokushima University
Torii, Yuta Tokushima University
Hirata, Yukina Tokushima University
Saijo, Yoshihito Tokushima University
Keywords
preload stress
right ventricular function
cardiac rehabilitation
exercise capacity
chronic heart failure
Content Type
Journal Article
Description
Cardiac rehabilitation had an important role in the management of heart failure. The predictors of exercise capacity improvement after cardiac rehabilitation are required in the management of heart failure. We demonstrated that patients with higher right ventricular strain during preload augmentation seem to have a benefit more from cardiac rehabilitation. The simple, but novel application of preload stress echocardiography is a noninvasive technique that can be used to find a beneficial group with cardiac rehabilitation.
Description Alternative
Background: It has been recognized that a comprehensive cardiac rehabilitation (CR) program improves mortality in patients with chronic heart failure (HF). On the other hand, the magnitude of the improvement in exercise capacity after CR differs among individuals. The aim of this study was to assess the echocardiographic determinants of responders to CR using preload stress echocardiography.
Methods: We prospectively enrolled 58 chronic HF patients with reduced left ventricular ejection fraction (LVEF) (age 62±11 years; 69% male; LVEF 43±7 %) who had received optimized medical treatment in a CR program for 5 months. We performed preload echocardiographic studies using leg positive pressure (LPP) to assess the echocardiographic parameters during preload augmentation. We defined 41 patients as a development cohort to assess the predictive value of echocardiographic variables. Next, we validated results in the remaining 17 patients as a validation cohort.
Results: In the development cohort, significant improvement in peak VO2 (>10%) after CR was observed in 58% patients. In a multivariable logistic regression model, the significant predictor of improvement in exercise capacity was right ventricular (RV) strain during LPP (odds ratio: 3.96 per 1 SD; p =0.01). A RV strain value of –16% during LPP had good sensitivity of 0.79 and specificity of 0.71 to identify patients with improvement in peak VO2. In the validation cohort, an optimal cut off value of RV strain value was the same (AUC: 0.77, sensitivity: 0.78, specificity: 0.65).
Conclusion: RV strain during LPP may be an echocardiographic parameter for assessing beneficial effects of CR.
Journal Title
Canadian Journal of Cardiology
ISSN
0828282X
NCID
AA10708957
AA12794009
Publisher
Canadian Cardiovascular Society|Elsevier
Volume
34
Issue
10
Start Page
1307
End Page
1315
Published Date
2018-06-07
Rights
© 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
EDB ID
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
Author
departments
University Hospital
Medical Sciences