CLINICAL AND ECOCARDIOGRAPHICS VARIABLES IN STRESS ECHOCARDIOGRAPHY AS PREDICTORS OF INTOLERANCE TO EXERCISE

ADAMEK B; RENNA NF; FAREZ B

PARIS

Congreso; EUROPEAN SOCIERY CONGRESS OF CARDIOLOGY 2019; 2019

ESC

Introduction: Daily activity requires at least 5 mets. Not reaching this limit is called exercise intolerance. Stress echocardiogram can confirm this in patients who are symptomatic or unmask it in asymptomatic patients. In this way, was can predict or determine the pathophysiological causes of intolerance to exercise. The objective of our work is evaluated that clinical and echo variables, baseline o during effort, can predict and / or unmask the cause of the symptoms.Methods: 164 patients were evaluated by stress echocardiography (ES) to establish a diagnosis and/or prognosis of coronary disease. The following was done: 1- pre-test questiony, 2- baseline echocardiography and ES. In 57 patients, also was determinate LV thicknesses, diameters and thickness, AI, contractile reserve, basal and intra-cardiac index, and baseline and exercise were measured. In the rest, central hemodynamic parameters were added Pulse wave velocity, central aortic pressure.Results: The average age was 62.31 years, males 64.1%., among 71% hypertensive, 29% was diabetic, 48.7% obesity, 18% with previous myocardial infarction, active smoker 38.4% and 37.8% dyslipidemic. As clinical predictors, baseline HT in patients without diagnosis compared to HT diagnosed and in treatment, had lower exercise capacity p = 0.0008. In baseline echocardiography, addition of LV hypertrophy + left atrial dilatation (indirect signs of diastolic dysfunction) predicted patients with Mets less than 5 (p = 0.03). The absence of an increase in LVEF with the effort (contractable reserve) greater than 4 nominal points and an increase of 1.5 in the cardiac index was also able to predict intolerance to effort (p = 0.0027). The correlation between different variables was weak. The pulse wave velocity was average due to less than 16, there being a negative correlation with respect to the Mets reached. The best predictor was baseline LVEF with r = 40.Conclusions: Hypertension in Baseline, contractile reserve with LVEF, CI and the indirect variables of diastolic dysfunction were significant predictors of exercise intolerance, of the rest the baseline LVEF had a weak positive correlat