title: Value of Baseline Cardiovascular Mechanics in Predicting Exercise Training Success.
abstract: OBJECTIVE
  Despite being repeatedly shown that exercise training (ET) increases exercise capacity and decreases mortality in many cardiac conditions, not all patients enjoy the benefits of ET programs. We hypothesized that baseline cardiovascular mechanic properties, including cardiac systolic and diastolic functions, arterial mechanics and ventriculoarterial interaction, may have a role in predicting response to ET.
  
  
  METHODS
  Full left ventricular pressure-volume loops were constructed and arterial mechanics were evaluated using echocardiographic and tonometric measurements. A cardiopulmonary exercise (CPX) test was performed before and after the ET program.
  
  
  RESULTS
  Sixty of the 75 patients with coronary artery disease or heart failure diagnoses completed the study. All of the CPX parameters showed a significant improvement with ET. The change in oxygen uptake correlated only with arterial parameters, such as compliance (r = 0.399, P = .002), end-systolic arterial elastance (r = -0.293, P = .02), aortic pulse pressure (r = -0.302, P = .02), and brachial pulse pressure (r = -0.312, P = .01). Receiver-operating characteristics analysis demonstrated that baseline arterial compliance and brachial pulse pressure predicted a significantly positive ET result with reasonable sensitivity and specificity.
  
  
  CONCLUSIONS
  Patients with a more compliant arterial system improved their exercise capacity more with ET. Evaluation of baseline arterial compliance may facilitate proper patient selection and may define patients who need optimizing measures for the arterial system before commencing ET. Even a simple blood pressure measurement may give clues in this regard.
authors.affiliation: Department of Cardiology (Dr Aslanger), Yeditepe University Hospital, Istanbul, Turkey; Université Paris-Descartes and Hôpital Européen Georges-Pompidou (Dr Assous), Paris, France; Department of Cardiology (Drs Assous, Bihry, Beauvais, Logeart, and Cohen-Solal), Assistance Publique-Hôpitaux de Paris, Paris, France; Department of Cardiology (Drs Bihry, Beauvais, Logeart, and Cohen-Solal), Lariboisiere Hospital, Paris, France; and Department of Cardiology (Drs Beauvais, Logeart, and Cohen-Solal), Université Paris Diderot, Paris, France.
authors.forename: Emre
authors.initials: E
authors.lastname: Aslanger
authors.forename: Benjamin
authors.initials: B
authors.lastname: Assous
authors.forename: Nicolas
authors.initials: N
authors.lastname: Bihry
authors.forename: Florence
authors.initials: F
authors.lastname: Beauvais
authors.forename: Damien
authors.initials: D
authors.lastname: Logeart
authors.forename: Alain
authors.initials: A
authors.lastname: Cohen-Solal
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000503:physiopathology; D062186:Arterial Pressure; D001916:Brachial Artery / Q000503:physiopathology; D000072038:Cardiac Rehabilitation; D003187:Compliance; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000534:rehabilitation*; D003971:Diastole; D015150:Echocardiography, Doppler; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006333:Heart Failure / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011446:Prospective Studies; D012372:ROC Curve; D013599:Systole; D016896:Treatment Outcome