Skip Navigation



European Heart Journal Advance Access published online on December 16, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi682
This Article
Right arrow Full Text (Rapid PDF)
Right arrow All Versions of this Article:
27/6/679    most recent
ehi682v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Ennezat, P. V.
Right arrow Articles by de Groote, P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ennezat, P. V.
Right arrow Articles by de Groote, P.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received October 9, 2005
Revised November 17, 2005
Accepted November 24, 2005

Clinical research

Myocardial asynchronism is a determinant of changes in functional mitral regurgitation severity during dynamic exercise in patients with chronic heart failure due to severe left ventricular systolic dysfunction

Pierre V. Ennezat 1 *, Sylvestre Maréchaux 2, Thierry Le Tourneau 2, Nicolas Lamblin 2, Christophe Bauters 2, Eric Van Belle 2, Benjamin Gal 2, Salem Kacet 2, Philippe Asseman 2, Ghislaine Deklunder 2, Thierry H. LeJemtel 3, and Pascal de Groote 2

1 Cardiology Hospital, Lille, France; Department of Medicine, Tulane University, New Orleans, LA, USA
2 Cardiology Hospital, Lille, France
3 Department of Medicine, Tulane University, New Orleans, LA, USA

* To whom correspondence should be addressed.
Pierre V. Ennezat, E-mail: ennezat{at}yahoo.com


  Abstract

Aims Functional mitral regurgitation (MR) and myocardial asynchronism occur commonly in patients with dilated cardiomyopathy and affect adversely their prognosis and symptoms. The aim of this study was to evaluate the mechanisms of changes in MR severity during dynamic exercise in patients with chronic heart failure (CHF).

Methods and results Seventy patients with CHF due to left ventricular (LV) systolic dysfunction [LV ejection fraction (EF)  < 40%] and functional MR were studied. All were in sinus rhythm. Medications were left unchanged for the study. Each patient performed a maximal symptom-limited exercise test with continuous 2D-Doppler echocardiography. Mitral regurgitant volume (RV) and effective regurgitant orifice (ERO) were determined at rest and during exercise. LV asynchrony using Doppler tissue imaging and interventricular asynchrony using conventional pulsed-Doppler were evaluated at rest.

Resting LV EF averaged 25 ± 8%. Mean resting LV and interventricular mechanical delays were 56 ± 50 and 43 ± 37 ms, respectively. The overall median values for mitral ERO and RV did not significantly change during dynamic exercise (11 [7-16] vs. 11 [6-21] mm2 and 14 [10-22] vs. 12 [9-23] mL, respectively). However, changes in mitral ERO and RV were individually variable and significantly correlated with the degree of LV asynchronism (r = 0.66, P < 0.0001 and r = 0.66, P < 0.0001, respectively).

Conclusion Changes in MR are variable during dynamic exercise. LV asynchronism at rest substantially contributes to worsening of functional MR during dynamic exercise in patients with CHF due to LV systolic dysfunction.

Keywords: Chronic heart failure; Exercise echocardiology; Mitral regurgitation; Myocardial asynchronism.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Eur J EchocardiogrHome page
E. Donal, C. De Place, G. Kervio, F. Bauer, R. Gervais, C. Leclercq, P. Mabo, and J.-C. Daubert
Mitral regurgitation in dilated cardiomyopathy: value of both regional left ventricular contractility and dyssynchrony
Eur J Echocardiogr, June 26, 2008; (2008) jen188v1.
[Abstract] [Full Text] [PDF]

Home page
 Eur J EchocardiogrHome page
P. Lancellotti, E. Donal, B. Cosyns, G. Van Camp, J.-L. Monin, E. Brochet, A. Berrebi, P. Pibarot, C. Chauvel, C. Hassager, et al.
Effects of surgery on ischaemic mitral regurgitation: a prospective multicentre registry (SIMRAM registry)
Eur J Echocardiogr, January 1, 2008; 9(1): 26 - 30.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
A. D'Andrea and R. Calabro
Effect of dynamic myocardial dyssynchrony on mitral regurgitation during supine bicycle exercise stress echocardiography in patients with idiopathic dilated cardiomyopathy and 'narrow 'QRS: reply
Eur. Heart J., October 2, 2007; 28(20): 2554 - 2555.
[Full Text] [PDF]

Home page
 Eur Heart JHome page
J. Madaric, M. Vanderheyden, C. Van Laethem, K. Verhamme, A. Feys, M. Goethals, S. Verstreken, P. Geelen, M. Penicka, B. De Bruyne, et al.
Early and late effects of cardiac resynchronization therapy on exercise-induced mitral regurgitation: relationship with left ventricular dyssynchrony, remodelling and cardiopulmonary performance
Eur. Heart J., September 1, 2007; 28(17): 2134 - 2141.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
A. D'Andrea, P. Caso, S. Cuomo, R. Scarafile, G. Salerno, G. Limongelli, G. Di Salvo, S. Severino, L. Ascione, P. Calabro, et al.
Effect of dynamic myocardial dyssynchrony on mitral regurgitation during supine bicycle exercise stress echocardiography in patients with idiopathic dilated cardiomyopathy and 'narrow' QRS
Eur. Heart J., April 2, 2007; 28(8): 1004 - 1011.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
L. A. Pierard and P. Lancellotti
Left ventricular dyssynchrony and dynamic functional mitral regurgitation: relationship or association?
Eur. Heart J., March 2, 2006; 27(6): 638 - 640.
[Full Text] [PDF]


Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.