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European Journal of Echocardiography Advance Access originally published online on December 6, 2008
European Journal of Echocardiography 2009 10(4):503-508; doi:10.1093/ejechocard/jen312
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Upright bicycle exercise echocardiography in patients with myocardial infarction shows lack of diastolic, but not systolic, reserve: a tissue Doppler study

Lene A. Rustad1, Brage H. Amundsen1,2,*, Stig A. Slørdahl1,2 and Asbjørn Støylen1,2

1 Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim N-7489, Norway
2 Department of Cardiology, St Olavs University Hospital, Trondheim, Norway

Received 22 June 2008; accepted after revision 16 November 2008; online publish-ahead-of-print 6 December 2008.

* Corresponding author. Tel: +47 73 59 88 88; fax: +47 73 59 86 13. E-mail address: brage.h.amundsen{at}ntnu.no


  Abstract

Aims: The aim of this feasibility study was to compare systolic and diastolic left ventricular (LV) function during upright bicycle exercise in patients with chronic myocardial infarction (MI).

Methods and results: Eighteen patients with first-time MI and no signs of heart failure at rest underwent upright bicycle exercise at 25, 50, and 75 W, and were compared with 18 age-matched controls. Systolic (S') and early (E') mitral annular velocities and early mitral filling velocity (E) were measured at each stage. LV ejection fraction was lower in the MI group (46 vs. 54%, P < 0.01), while end-diastolic volumes were similar. S' was lower in the MI patients, but increased during exercise in both groups. E' was similar at rest, but increased in the control group only. Early mitral filling (E) increased in both groups, thus the E/E' ratio increased during exercise in the MI group only. Heart rate was similar in both groups.

Conclusions: Upright exercise echocardiography is feasible and can unmask early diastolic dysfunction and increased LV filling pressures in patients with small prior MIs.

Keywords: Echocardiography; Exercise; Myocardial infarction; Diastole; Tissue Doppler imaging


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