title: [Disproportionate shortening of left ventricular diastolic duration in patients with dilated cardiomyopathy].
abstract: OBJECTIVE
  Cardiac performance can be characterized in terms of the relative duration of systole and diastole. In pediatric patients with dilated cardiomyopathy (DCM), a disproportionate shortening of left ventricular diastole was observed. The present study was intended to reproduce these findings in an adult patient group and to evaluate exercise-related changes of both time intervals.
  
  
  METHODS
  Exercise radionuclide angiography was used in 61 patients with DCM NYHA (New York Heart Association) stage II-III. The phases of the cardiac cycle were derived from a radionuclide time-activity curve with high temporal resolution. The control group consisted of 26 patients referred for ventricular function assessment with radionuclide angiography before cardiotoxic cancer treatment.
  
  
  RESULTS
  When the duration of systole was expressed as the product of systolic time and heart rate, DCM patients exhibited a significant increase in left ventricular systolic time at rest (23.9 vs. 21.5 s/min; p = 0.006) and during peak exercise (29.2 vs. 26.7 s/min; p = 0.01). The prolongation of left ventricular systole at peak exercise was evident, although the peak heart rate was significantly lower in the patient group than in the control group (118 vs. 127/min; p = 0.04). In DCM patients the diastolic time loss per beat was further quantified using a regression equation obtained from the healthy control group. A significant shortening of left ventricular diastolic time was confirmed during peak exercise. Furthermore, a progressive loss in diastolic time per beat from rest to peak exercise was noted.
  
  
  CONCLUSIONS
  Cardiac cycle abnormalities of patients with DCM are characterized by a prolongation of left ventricular systole and an abnormal shortening of left ventricular diastole. The systolic-diastolic mismatch is accentuated during exercise and has the potential to impair the cardiac reserve in these patients by restricting ventricular filling and perfusion.
authors: Medizinische Klinik II (Schwerpunkte Kardiologie und Angiologie), Marienhospital Herne, Ruhr-Universität, Bochum. gunnar.plehn@ruhr-uni-bochum.de
authors: Gunnar
authors: G
authors: Plehn
authors: Julia
authors: J
authors: Vormbrock
authors: Christian
authors: C
authors: Zühlke
authors: Martin
authors: M
authors: Christ
authors: Christian
authors: C
authors: Perings
authors: Stefan
authors: S
authors: Perings
authors: Hans-Joachim
authors: HJ
authors: Trappe
authors: Axel
authors: A
authors: Meissner
mesh_terms: D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000503:physiopathology*; D003971:Diastole / Q000502:physiology*; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D015637:Gated Blood-Pool Imaging; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology*