title: Noninvasive assessment of exercise tolerance using mitral annular velocities.
abstract: OBJECTIVE
  To investigate the feasibility of evaluating exercise tolerance using lateral and septal mitral annular velocities in patients with preserved left ventricular ejection fraction (LVEF) and those with reduced LVEF.
  
  
  METHODS
  We studied 36 patients with LVEF ≥50% and 36 with LVEF <50%. We measured peak early diastolic velocity of transmitral flow (E) and peak early diastolic velocities of the lateral (LEa) and septal (SEa) mitral annulus. The ratios of E to LEa (E/LEa) and E to SEa (E/SEa) were calculated. We measured peak oxygen consumption [Formula: see text] and anaerobic threshold (AT) by cardiopulmonary exercise testing.
  
  
  RESULTS
  In patients with LVEF ≥50%, E/LEa correlated well with [Formula: see text] and AT (r = -0.69 and r = -0.74, respectively; p < 0.001); E/SEa correlated modestly (r = -0.59 and r = -0.60, respectively; p < 0.001). In patients with LVEF <50%, E/LEa correlated well with [Formula: see text] and AT (r = -0.72 and r = -0.76; respectively, p < 0.001); E/SEa correlated modestly (r = -0.63 and r = -0.63, respectively; p < 0.001).
  
  
  CONCLUSIONS
  E/LEa may be more useful than E/SEa for the noninvasive estimation of exercise tolerance, throughout a wide range of LVEF.
authors.affiliation: Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan. hytch@hotmail.co.jp.|Division of Cardiology, Tokuyama Central Hospital, 1-1 Kodacho, Shunan, 745-8522, Japan. hytch@hotmail.co.jp.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Hadano
authors.affiliation: Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Masunori
authors.initials: M
authors.lastname: Matsuzaki
mesh_terms: D004452:Echocardiography / Q000379:methods*; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005240:Feasibility Studies; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: Exercise tolerance; Mitral annular velocity; Tissue Doppler imaging