Journal of the American Society of Echocardiography
Volume 23, Issue 5 , Pages 523-530 , May 2010

Passive Leg-Raise Is Helpful to Identify Impaired Diastolic Functional Reserve During Exercise in Patients With Abnormal Myocardial Relaxation

  • Eui-Young Choi, MD, PhD

      Affiliations

    • Cardiology Division, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
  • ,
  • Chi Young Shim, MD

      Affiliations

    • Cardiology Division, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea
  • ,
  • Sung-Ai Kim, MD

      Affiliations

    • Cardiology Division, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
  • ,
  • Sang Jae Rhee, MD

      Affiliations

    • Cardiology Division, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
  • ,
  • Donghoon Choi, MD, PhD

      Affiliations

    • Cardiology Division, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea
  • ,
  • Se-Joong Rim, MD, PhD

      Affiliations

    • Cardiology Division, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
  • ,
  • Yangsoo Jang, MD, PhD

      Affiliations

    • Cardiology Division, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea
  • ,
  • Namsik Chung, MD, PhD

      Affiliations

    • Cardiology Division, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea
  • ,
  • Seung-Yun Cho, MD, PhD

      Affiliations

    • Cardiology Division, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea
  • ,
  • Jong-Won Ha, MD, PhD

      Affiliations

    • Cardiology Division, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea
    • Corresponding Author InformationReprint requests: Jong-Won Ha, MD, PhD, Cardiology Division, Yonsei Cardiovascular Center and Cardiovascular Research Institute, Seodaemun-gu, Shinchon-dong 134, Seoul 120-752, South Korea.

References 

  1. Zile MR, Baicu CF, Gaasch WH. Diastolic heart failure-abnormalities in active relaxation and passive stiffness of the left ventricle. N Engl J Med. 2004;350:1953–1959
  2. Appleton C, Hatle L, Popp R. Relation of transmitral flow velocity patterns to left ventricular diastolic function: new insights from a combined hemodynamic and Doppler echocardiographic study. J Am Coll Cardiol. 1988;12:426–440
  3. Nishimura R, Tajik AJ. Evaluation of diastolic filling of left ventricle in health and disease: Doppler echocardiography is the clinician's Rosetta stone. J Am Coll Cardiol. 1997;30:8–18
  4. Nagueh S, Middleton K, Kopelen H, Zoghbi WA, Quiñones MA. Doppler tissue imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. J Am Coll Cardiol. 1997;30:1527–1533
  5. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16:31–41
  6. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography's guidelines and standards committee and the chamber quantification writing group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18:1440–1463
  7. Quinones MA, Waggoner AD, Reduto LA, Nelson JG, Young JB, Winters WL, et al. A new, simplified and accurate method for determining ejection fraction with two-dimensional echocardiography. Circulation. 1981;64:744–753
  8. Kelly RP, Ting C-T, Yang T-M, Liu CP, Maughan WL, Chang MS, et al. Effective arterial elastance as index of arterial vascular load in humans. Circulation. 1992;86:513–521
  9. Ha JW, Oh JK, Pellikka PA, Stussy VL, Bailey KR, Seward JB, et al. Diastolic stress echocardiography: a novel noninvasive diagnostic test for diastolic dysfunction using supine bicycle exercise Doppler echocardiography. J Am Soc Echocardiogr. 2005;18:63–68
  10. Choi EY, Ha JW, Rim SJ, Kim SA, Yoon SJ, Shim CY, et al. Incremental value of left ventricular diastolic function reserve index for predicting exercise capacity in patients with hypertrophic cardiomyopathy. J Am Soc Echocardiogr. 2008;21:487–492
  11. Ha JW, Lee HC, Kang ES, Ahn CM, Kim JM, Ahn JA, et al. Abnormal left ventricular longitudinal functional reserve in patients with diabetes mellitus: Implication for detecting subclinical myocardial dysfunction using exercise tissue Doppler echocardiography. Heart. 2007;93:1571–1576
  12. Nonogi H, Hess OM, Ritter M, Krayenbuehl HP. Diastolic properties of the normal left ventricle during supine exercise. Br Heart J. 1988;60:30–38
  13. Kumar A, Anel R, Bunnell E, Zanotti S, Habet K, Haery C, et al. Preload-independent mechanisms contribute to increased stroke volume following large volume saline infusion in normal volunteers: a prospective interventional study. Crit Care. 2004;8:R128–R136
  14. Nagueh SF, Sun H, Kopelen HA, Middleton KJ, Khoury DS. Hemodynamic determinants of the mitral annulus diastolic velocities by tissue Doppler. J Am Coll Cardiol. 2001;37:278–285
  15. Westermann D, Kasner M, Steendijk P, Spillmann F, Riad A, Weitmann K, et al. Role of left ventricular stiffness in heart failure with normal ejection fraction. Circulation. 2008;117:2051–2060
  16. Sibbald WJ, Paterson NAM, Hoiliday RL, Baskerville J. The Trendelenburg position: hemodynamic effects in hypotensive and normotensive patients. Crit Care Med. 1979;7:218–224
  17. Kyriakides ZS, Koukoulas A, Paraskevaidis IA, Chrysos D, Tsiapras D, Galiotos C, et al. Does passive leg raising increase cardiac performance? A study using Doppler echocardiography. Int J Cardiol. 1994;44:288–293
  18. Pozzoli M, Traversi E, Cioffi G, Stenner R, Sanarico M, Tavazzi L. Loading manipulations improve the prognostic value of Doppler evaluation of mitral flow in patients with chronic heart failure. Circulation. 1997;95:1222–1230
  19. Burgess MI, Jenkins C, Sharman JE, Marwick TH. Diastolic stress echocardiography: hemodynamic validation and clinical significance of estimation of ventricular filling pressure with exercise. J Am Coll Cardiol. 2006;47:1891–1900
  20. Garcia MJ. Can tissue Doppler echocardiography detect subclinical myocardial dysfunction in patients with diabetes?. Nat Clin Pract Cardiovasc Med. 2007;4:590–591
  21. Ha JW, Lee HC, Park S, Choi EY, Seo HS, Shim CY, et al. Gender-related difference in left ventricular diastolic elastance during exercise in patients with diabetes mellitus. Circ J. 2008;72:1443–1448
  22. Park S, Ha JW, Shim CY, Choi EY, Kim JM, Ahn JA, et al. Gender-related difference in arterial elastance during exercise in patients with hypertension. Hypertension. 2008;51:1163–1169

 This work was supported by grant M10642120001-06N4212-00110 from the Korea Science and Engineering Foundation (Seoul, Korea).

PII: S0894-7317(10)00101-X

doi: 10.1016/j.echo.2010.02.004

Journal of the American Society of Echocardiography
Volume 23, Issue 5 , Pages 523-530 , May 2010