Ee-May Chia1, Calvin H C Hsieh2, Phuong Pham1, Jane Vidaic1, Wei Xuan1, Dominic Leung1, Liza Thomas3. 1. Liverpool Hospital, University of New South Wales, Sydney, Australia. 2. Liverpool Hospital, University of New South Wales, Sydney, Australia; Westmead Hospital, Sydney, Australia. 3. Liverpool Hospital, University of New South Wales, Sydney, Australia. Electronic address: l.thomas@unsw.edu.au.
Abstract
BACKGROUND: Right ventricular (RV) function augments with exercise, and loss of this adaptive ability often determines symptoms. Reports on exercise-related changes in RV function in healthy subjects are sparse. In this study, healthy volunteers were prospectively recruited, and changes in RV function with exercise were examined, optimal parameters determined, and the effects of gender and age examined. METHODS: Treadmill exercise stress echocardiography with concurrent expired gas analysis was performed in 121 healthy volunteers. Parameters of RV systolic function (RV fractional area change, Doppler tissue s' velocity, and systolic strain and strain rate) and diastolic function (peak E and A velocity, Doppler tissue e', a' and early and late diastolic strain rate) were evaluated at baseline and after exercise, with the difference (Δ) being systolic and diastolic reserve. Changes in pulmonary arterial pressure (PAP) was measured when accurate estimation was possible. RESULTS: Most systolic functional parameters were augmented with exercise. However, systolic augmentation decreased with age (Δs': r = -0.31, P < .01; Δ strain: r = -0.28, P = .008; Δ systolic strain rate: r = -0.31, P < .01). Similar changes were observed with diastolic function (Δe': r = -0.33, P < .01; Δ early diastolic strain rate r = -0.20, P = .04). In the subgroup with PAP measurements, ΔPAP (r = 0.32, P < .01) increased with age. Men had greater augmentation of systolic reserve, but differences were negated when corrected for workload. S' velocity was the most robust measure of RV systolic function. CONCLUSIONS: There is a modest yet significant reduction in RV systolic and diastolic reserve with age, with an increase in PAP. S' velocity is a robust and feasible measure that should be considered given the increasing use of stress testing to evaluate RV function. Crown
BACKGROUND: Right ventricular (RV) function augments with exercise, and loss of this adaptive ability often determines symptoms. Reports on exercise-related changes in RV function in healthy subjects are sparse. In this study, healthy volunteers were prospectively recruited, and changes in RV function with exercise were examined, optimal parameters determined, and the effects of gender and age examined. METHODS: Treadmill exercise stress echocardiography with concurrent expired gas analysis was performed in 121 healthy volunteers. Parameters of RV systolic function (RV fractional area change, Doppler tissue s' velocity, and systolic strain and strain rate) and diastolic function (peak E and A velocity, Doppler tissue e', a' and early and late diastolic strain rate) were evaluated at baseline and after exercise, with the difference (Δ) being systolic and diastolic reserve. Changes in pulmonary arterial pressure (PAP) was measured when accurate estimation was possible. RESULTS: Most systolic functional parameters were augmented with exercise. However, systolic augmentation decreased with age (Δs': r = -0.31, P < .01; Δ strain: r = -0.28, P = .008; Δ systolic strain rate: r = -0.31, P < .01). Similar changes were observed with diastolic function (Δe': r = -0.33, P < .01; Δ early diastolic strain rate r = -0.20, P = .04). In the subgroup with PAP measurements, ΔPAP (r = 0.32, P < .01) increased with age. Men had greater augmentation of systolic reserve, but differences were negated when corrected for workload. S' velocity was the most robust measure of RV systolic function. CONCLUSIONS: There is a modest yet significant reduction in RV systolic and diastolic reserve with age, with an increase in PAP. S' velocity is a robust and feasible measure that should be considered given the increasing use of stress testing to evaluate RV function. Crown
Authors: Shivani M Bhatt; Yan Wang; Okan U Elci; Elizabeth Goldmuntz; Michael McBride; Stephen Paridon; Laura Mercer-Rosa Journal: J Am Soc Echocardiogr Date: 2018-09-27 Impact factor: 5.251
Authors: Aseem Pradhan; John Scaringi; Patrick Gerard; Ross Arena; Jonathan Myers; Leonard A Kaminsky; Ethan Kung Journal: Cardiovasc Eng Technol Date: 2021-10-19 Impact factor: 2.305