Doppler mitral inflow variables time course after treadmill stress echo with and without ischemic response

This study evaluated Doppler mitral inflow variables changes from rest to post-exercise among 104 subjects with and without echocardiographic evidence of ischemic response (IR) to exercise (63.9 +/- 11 years, 54% male, 32% with IR) who underwent a clinically indicated treadmill stress echo (TSE) test. The time from exercise cessation to imaging (TIME) was recorded. The changes (after TSE minus baseline values) in the peak E-wave velocity (Delta E) [34.2 vs. 24.2, p = 0.024] and E-wave deceleration rate (Delta DR) [348.0 vs. 225.7, p = 0.010] were bigger in ischemic than in nonischemic subjects, while the changes in the peak A-wave velocity (Delta A) did not differ [7.9 vs. 15.0, p = 0.082]. The correlations between Doppler variables and IR, TIME, and TIME x IR interaction were analyzed. We observed a significant interaction between TIME and IR regarding Delta E and Delta DR. The differences in the regression line slopes of time courses for Delta E and Delta DR based on IR were significant: Delta E (- 0.09 vs. - 8.17, p = 0.037) and Delta DR (11.23 vs. - 82.60, p = 0.022). Main findings: (1) Time courses after exercise of Delta E and Delta DR in subjects with and without IR were different. (2) Delta E and Delta DR did not differ between subjects with and without IR at exercise cessation (TIME= 0). (3) The simple main effect of ischemia on Delta E and Delta DR was significant at TIME of >= 3 min. Divergent time courses of Delta E and Delta DR after exercise might be promising for detecting diastolic dysfunction caused by ischemia. [GRAPHICS] .

Automated summary

This study evaluated changes in Doppler mitral inflow variables from rest to post-exercise in subjects with and without echocardiographic evidence of ischemic response. The results showed that the changes in peak E-wave velocity and E-wave deceleration rate were bigger in ischemic subjects compared to nonischemic subjects. There was a significant interaction between time from exercise cessation to imaging and ischemic response.