title: [Echocardiographic predictors of exercise capacity in patients with heart failure and systolic dysfunction: role of mitral regurgitation].
abstract: OBJECTIVE
  Patients with heart failure and similar left ventricular systolic dysfunction have differing exercise capacity. The aim of this study was to identify echocardiographic predictors of exercise capacity in patients with heart failure and systolic dysfunction.
  
  
  METHODS
  We included 150 patients with class II (70%) or III (30%) heart failure with left ventricular ejection fraction below 40%. Six-minute walking test and cardiac color Doppler-echo, including tissue Doppler of mitral and tricuspid rings, were performed. Moderate and severe mitral regurgitation were considered as significant. Two groups were divided according to the median walking distance (290 m): Group 1, <290 m and Group 2, ≥290 m.
  
  
  RESULTS
  Mitral regurgitation was detected in 112 patients (75%), which was significant in 40 (27%). Group 1 showed more significant mitral regurgitation (35 vs 18%), increased left atrium area (27±1 vs 24±1cm(2)), mitral E amplitude (88±5 vs 72±3cm/s) and systolic pulmonary pressure (37±1 vs 32±1mmHg, all P<.05). By logistic regression analysis, only the presence of significant mitral regurgitation was independently associated with less walked distance (odds ratio: 3.44 95% confidence interval 1.02-11.66, P<.05). By multiple linear regression, the only independent predictor of walked distance was left atrium area (r=0.25, beta coefficient: -6.52±2, P<.01).
  
  
  CONCLUSIONS
  In patients with class II-III heart failure and left ventricular systolic dysfunction, the main echocardiographic predictors of exercise capacity are related to the presence of significant mitral regurgitation.
authors: Servicios de Cardiología Clínica e Imágenes, Instituto Cardiovascular de Buenos Aires (ICBA), Buenos Aires, Argentina.
authors: Marcelo
authors: M
authors: Trivi
authors: Jorge
authors: J
authors: Thierer
authors: Paola
authors: P
authors: Kuschnir
authors: Adriana
authors: A
authors: Acosta
authors: Javier
authors: J
authors: Marino
authors: Ramiro
authors: R
authors: Guglielmone
authors: Ricardo
authors: R
authors: Ronderos
mesh_terms: D000368:Aged; D004452:Echocardiography; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology; D054143:Heart Failure, Systolic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011237:Predictive Value of Tests; D016138:Walking