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European Heart Journal 1992 13(3):356-359;
Copyright © 1992 by the European Society of Cardiology.
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© 1992 The European Society of Cardiology

Ascending aortic Doppler velocity and the prediction of exercise capacity in post-infarction left ventricular dysfunction

A. J. S. COATS, S. ADAMOPOULOS, J. E. ISEA, J. CONWAY, C. MURPHY and P. SLEIGHT

Cardiac Department, John Radcliffe Hospital Oxford, U.K.

Received 16 July 1990; revised 29 May 1991; .

Correspondence. Dr A. Coats. National Heart nd Lung Institute. Duvehouse Street, London SW3 6LY. U. K.

Abstract

A system to improve analysis of the aortic pulsed Doppler velocity signal has been developed and used to study cardiac performance during a 4 min, 25 W incremental stage supine bicycle exercise to exhaustion. Twenty-two male subjects with stable chronic ischaemic heart disease were studied (15 with NYHA class II/III heart failure, and seven age-matched class I subjects). None had evidence of reversible ischaemia. Peak velocity (PV) from the intensity weighted mean velocity profile, early acceleration (eA) and stroke distance (SD) were all significantly lower at rest in class II/III compared to classI. For the change from rest to 50 W. PV did not alter. eAC increased significantly (P <0.05) and to a similar extent in both groups (18.6% class II/III vs 16.4% class I) and SD was reduced from 7.8 to 5.9 in classII/III (P <0.01) but did not change in class I (12.4 vs 11.8, ns). There was also a greater increase in heart rate (HR) in class II/III subjects (P < 0.05). The duration of exercise was correlated with resting PV (r = 0.48, P < 0.025) but was correlated best with the change in blood momentum (PVxStroke volume x HR) between rest and peak exercise (r=0.80, P.<0.001). Thus Doppler velocimetry can give quantitative information on the response to exercise which discriminates between grades of ventricular dysfunction and is predictive of exercise capacity.

Key Words: Heart failure • Doppler ultrasound • exercise


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