著者
WANG Mei YAN Guo-Hui YUE Wen-Sheng SIU Chung-Wah YIU Kai-Hang LEE Stephen W. L. LAU Chu Pak TSE Hung-Fat
出版者
一般社団法人 日本循環器学会
雑誌
Circulation journal : official journal of the Japanese Circulation Society (ISSN:13469843)
巻号頁・発行日
vol.76, no.3, pp.682-688, 2012-02-25
参考文献数
35
被引用文献数
1 9

<b><i>Background:</i></b> Left ventricular (LV) mechanical dyssynchrony can lead to impairment of LV function and is associated with adverse clinical outcomes in coronary artery disease (CAD) patients. The impact of LV dyssynchrony on exercise capacity (EC) in patients with CAD was investigated. <b><i>Methods and Results:</i></b> An echocardiographic examination with tissue Doppler imaging and exercise treadmill testing in 151 CAD patients with normal LV ejection fraction was performed. LV intra- and inter-ventricular dyssynchrony were defined by the standard deviation of time interval between LV 6 basal segments (Ts-SD), and the time interval from the right ventricular (RV) free wall to LV lateral wall (Ts-RV) respectively, and EC was measured as metabolic equivalents (METs) on the treadmill. Patients with impaired EC (defined by a METs &le;8, which is the mean MET of the study population) were older (71&plusmn;7 vs. 62&plusmn;2 years, P<0.01), however, there were no differences in gender and clinical status such as prevalence of prior myocardial infarction (MI), regional wall motion abnormality (RWMA), and coronary revascularization between patients with (n=90) or without (n=61) impaired EC. Univariate analysis showed that age, body mass index, LV systolic and diastolic volume, mitral inflow A velocity, and Ts-SD were all significantly associated with METs (all P<0.05). However, multivariate regression analysis revealed that old age (odd ratio [OR]: 1.136, 95% confidence interval [CI]: 1.080-1.196, P<0.001), and Ts-SD (OR: 1.026, 95%CI: 1.003-1.049, P=0.027) only were independent predictors for impaired EC. <b><i>Conclusions:</i></b> In patients with CAD, LV systolic dyssynchrony predicts impaired EC independently of history of previous MI or RWMA. (<i>Circ J</i> 2012; <b>76:</b> 682-688)<br>