Association between baseline cardiovascular mechanics and exercise capacity in patients with coronary artery disease
نویسندگان
چکیده
OBJECTIVE Functional capacity is one of the cardinal determinants of morbidity and mortality in patients with coronary artery disease (CAD). We hypothesized that baseline cardiovascular mechanics, including cardiac systolic and diastolic functions, arterial mechanics, and ventriculoarterial interaction, may play a role in predicting exercise capacity in patients with CAD. METHODS Fifty consecutive patients with CAD who were referred to cardiac rehabilitation were prospectively included in the study. Patients with non-sinus rhythms or severe valvular disease were excluded. Full left ventricular pressure-volume loops were constructed and arterial mechanics was evaluated using echocardiographic and tonometric measurements. Cardiopulmonary exercise tests were performed to measure exercise capacity. RESULTS Fifty patients were enrolled in the study. Ventriculo-arterial coupling showed a moderate correlation with peak oxygen consumption (VO2) (r=0.410, p=0.04) in patients with reduced left ventricular ejection fraction (LVEF). Only left ventricular volume at 15 mm Hg (r=0.514, p<0.01) in diastolic parameters (stiffness constant, p=0.75; ventricular compliance, p=0.17) and arterial compliance (r=0.467, p=0.01) in arterial parameters [arterial elastance, p=0.27; systemic vascular resistance, p=0.45; augmentation pressure, p=0.85; augmentation index (AIx), p=0.63; heart rate-corrected AIx, p=0.68] emerged as significant factors correlated with peak VO2 in patients with normal LVEF. CONCLUSION Comprehensive evaluation of resting cardiovascular mechanics can give clues about exercise-recruited reserves of the cardiovascular system. Optimization of ventriculo-arterial coupling in patients with reduced LVEF and arterial compliance in patients with normal LVEF should be the main target in patients with CAD and limited functional capacity.
منابع مشابه
Insulin resistance and coronary artery disease in non-diabetic patients: Is there any correlation?
Background: Cardiovascular diseases are the most common causes of death in the world and type 2 diabetes is one of them because it is highly prevalent and doubles heart disease risk. Some studies suggest that insulin resistance is associated with coronary artery disease in non-diabetics. The aim of this study was to evaluate the association of insulin resistance (IR) and coronary artery disease...
متن کاملAssociation between T-786C polymorphism of endothelial nitric oxide synthase gene and level of the vessel dilation factor in patients with coronary artery disease
Various polymorphisms on endothelial nitric oxide synthase (eNOs) gene cause reduced production of NO, the endothelial relaxing factor, and may accelerate the process of atherosclerosis. The study designed to investigate the frequency of T-786C polymorphism of the eNOs gene in patients suffering from coronary artery disease (CAD) in north-west of Iran. One hundred twenty subjects including 60 p...
متن کاملRetraction note: Association between T-786C polymorphism of endothelial nitric oxide synthase gene and level of the vessel dilation factor in patients with coronary artery disease
متن کامل
Correlation Between Aortic Valve Sclerosis and Coronary Artery Disease: A Cross - Sectional Study
Introduction: Aortic valve sclerosisis considered as a manifestation of coronary atherosclerosis. Recent studies demonstrated an association between aortic valve sclerosis and obstructive coronary artery disease. The purpose of this study was to evaluatethe correlation betweenaortic valve sclerosis andobstructive coronary artery disease and the extent of coronary artery disease in patients ho...
متن کاملThe Association of Glomerular Filtration Rate with Coronary Artery Disease in Type 2 Diabetic Patients
Objective: Chronic kidney disease (CKD) and diabetes mellitus can influence coronary artery disease (CAD) independently. The aim of this study was to evaluate the association of glomerular filtration rate (GFR) and CAD in type 2 diabetic patients (T2DM). Materials and Methods: This cross sectional study evaluated 3624 T2DM patients with clinical presentation of CAD whose documents were registe...
متن کامل