Hemodynamic stress echocardiography in patients supported with a continuous-flow left ventricular assist device.
Functional assessment of continuous-flow left ventricular assist devices (LVADs) is usually performed with the patient at rest. This study compared echocardiographic indices of contraction and filling pressure with invasive measures in 12 ambulatory LVAD patients undergoing symptom-limited bicycle exercise. Exercise induced an increase in cardiac output, systolic pulmonary artery pressure, and diastolic pulmonary artery pressure. Although no changes in left ventricular dimensions or fractional shortening were seen on echocardiography, systolic mitral annular motion (S') increased significantly (in parallel with cardiac output) and diastolic E/e' ratio decreased (correlating inversely with diastolic pulmonary artery pressure). These findings emphasize the potential role of exercise echocardiography in studying exercise hemodynamics in LVAD patients.
Andersen
Mads
M
Department of Cardiology, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Gustafsson
Finn
F
Madsen
Per Lav
PL
Brassard
Patrice
P
Jensen
Anette Schophuus
AS
Secher
Niels
N
Hassager
Christian
C
Nordsborg
Nikolai
N
Møller
Jacob Eifer
JE
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002302:Cardiac Output; D003718:Denmark; D015150:Echocardiography, Doppler; D018619:Echocardiography, Doppler, Pulsed; D025401:Echocardiography, Stress; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D009200:Myocardial Contraction; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D012720:Severity of Illness Index; D016277:Ventricular Function, Left; D017725:Ventricular Pressure; D055815:Young Adult