Abnormalities of left ventricular diastolic function linked to exercise capacity

Abnormalities of left ventricular function were associated with exercise capacity, according to a cross-sectional study.

Researchers examined the measures of cardiac function in 2,867 patients. Diastolic dysfunction was inversely associated with exercise capacity. Lower exercise capacity was observed for patients with moderate/severe resting diastolic dysfunction (exercise capacity in metabolic equivalents =–1.30; 95% CI, –1.52 to –0.99); mild resting diastolic dysfunction (METs=–0.70; 95% CI, –0.88 to –0.46).

Variation of LV systolic function within the normal range was not linked to exercise capacity. There was a reduction in exercise capacity for LV filling pressures measured by resting E/e’ >15 or post-exercise E/e’ (METs=–0.41; 95% CI, –0.70 to –0.11). There was a progressive increase in the magnitude of reduction in exercise capacity with advanced age for those with impaired relaxation (P<.001) or resting E/e’ ≥15 (P=.02). Age (METs=–0.85; 95% CI, –0.92 to –0.77), female sex (METs=–1.98; 95% CI, –2.15 to –1.84) and BMI >30 (METs=–1.24; 95% CI, –1.41 to –1.10) were independent correlates of exercise capacity. – by Christen Haigh

JAMA. 2009;301:286-294.

While systolic and diastolic function are inextricably linked, there is growing awareness of the importance of assessing the independent contribution of abnormal diastolic function to overall CV performance. This study shows that exercise performance is related to diastolic function. A key element lacking in the clinical evaluation of diastolic function is the absence of effective therapy to reverse the observed abnormalities.

– Samuel L. Wann, MD

Chairman, Department of Cardiovascular Medicine
Wisconsin Heart Hospital, Wauwatosa, Wis.