Radionuclide angiographic exercise left ventricular performance in chronic aortic regurgitation: relationship to resting echographic ventricular dimensions and systolic wall stress index.
Forty-five patients with chronic aortic regurgitation (AR) underwent first-pass radionuclide angiocardiography (RNA) at rest and during upright bicycle exercise, as well as M-mode echocardiography at rest. Abnormal left ventricular (LV) exercise reserve, defined by the absolute change in ejection fraction (EF), was present in 16 of 45 patients (36%). Seven of ten patients with abnormal resting EF (less than 50%) and three of seven symptomatic patients had normal LV exercise responses. Patients with normal LV exercise reserve by RNA had LV dimensions by echo at end diastole (5.9 +/- 0.2 vs 6.5 +/- 0.3 cm, p = NS) and end systole (3.9 +/- 0.2 vs 4.4 +/- 0.3 cm, p = NS) comparable to those in patients wht abnormal LV exercise reserve. However, the mean corrected LV end-diastolic (LVED) radius/wall thickness ratio was significantly greater in AR patients with abnormal LV exercise reserve than in those with normal LV exercise reserve (395 +/- 15 vs 315 +/- 16, p less than 0.01). There data suggest that resting echocardiographic LV dimensions as well as the corrected echo LVED radius/wall thickness ratio have a variable relationship to RNA LV exercise performance in patients with chronic AR.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001794:Blood Pressure; D002908:Chronic Disease; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011674:Pulse; D011877:Radionuclide Imaging; D013599:Systole