title: Left ventricular diastolic filling dynamics during isometric exertion in syndrome X assessed with Doppler flowmetry.
abstract: To study left ventricular diastolic properties in syndrome X, we analyzed transmitral filling dynamics during handgrip exertion. In 14 normal subjects (N), 17 with syndrome X (Syn X), 16 with single-vessel disease (SVD), and 8 with multiple-vessel disease (MVD), transmitral inflow was recorded at baseline and during handgrip (50% of maximal effort for one minute) using pulsed Doppler echocardiography. We measured early diastolic (E) and late atrial (A) inflow velocities, A/E ratio and percent change of A/E from baseline (%A/E). Blood pressure and heart rate increased to the same degree in each group during handgrip. In normal subjects, E did not change with handgrip; A (51 +/- 10 vs 54 +/- 11 cm/sec, P < 0.05) and A/E (1.16 +/- 0.22 vs 1.25 +/- 0.33, P < 0.05) increased minimally. In Syn X subjects, E decreased (51 +/- 10 vs 38 +/- 10 cm/sec, P < 0.0001), A increased (52 +/- 11 vs 60 +/- 14 cm/sec, P < 0.005), and A/E increased markedly (1.07 +/- 0.31 vs 1.68 +/- 0.51, P < 0.0001). The %A/E in Syn X and MVD were significantly larger than that in SVD and N (Syn X: 58 +/- 29%; MVD: 45 +/- 25%; SVD: 22 +/- 21%; N: 8 +/- 13%). Handgrip-induced changes in diastolic filling in syndrome X and are similar to those in MVD and more marked than in SVD. These changes are consistent with impaired ventricular relaxation and support a generalized left ventricular (LV) abnormality in syndrome X.
authors.affiliation: Second Department of Internal Medicine, Kagawa Medical University, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Mizushige
authors.forename: H
authors.initials: H
authors.lastname: Masugata
authors.forename: H
authors.initials: H
authors.lastname: Morita
authors.forename: S
authors.initials: S
authors.lastname: Senda
authors.forename: H
authors.initials: H
authors.lastname: Matsuo
mesh_terms: D000328:Adult; D000368:Aged; D016279:Atrial Function, Left / Q000502:physiology; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology*; D015331:Cohort Studies; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology; D003971:Diastole; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology; D008297:Male; D017566:Microvascular Angina / Q000503:physiopathology*; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D009200:Myocardial Contraction / Q000502:physiology; D005082:Physical Exertion / Q000502:physiology*; D013318:Stroke Volume / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*; D017725:Ventricular Pressure / Q000502:physiology