{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:36:21Z","timestamp":1781915781886,"version":"3.54.5"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T00:00:00Z","timestamp":1645056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Exercise echocardiography (ExE) may evaluate left ventricular (LV) systolic and diastolic function. We aimed to assess the value of diastolic parameters at exercise [early LV inflow velocity to early tissue Doppler annulus velocity (E\/e\u2032)] in patients with normal or abnormal resting diastolic function (DF) referred for a clinically indicated ExE.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>LV systolic and DF according to ASE\/EACVI guidelines and mitral regurgitation (MR) were evaluated at rest in 772 patients (age 67 \u00b1 12 years) with preserved LV ejection fraction (LVEF \u2265 50%). We assessed regional\/global LV systolic function at peak exercise, while MR and E\/e\u2032 where evaluated in the immediate post-exercise period. Abnormal ExE was defined as ischaemia or fixed wall motion abnormalities, and raised E\/e\u2032 values as &amp;gt;15 at rest and at exercise (e\u2032 at the septal level). Patients were grouped as complaining or not of dyspnoea. Events were overall mortality, myocardial infarction, admission for unstable angina or cardiac failure, and coronary revascularization. DF was abnormal at rest in 221 patients (29%) and indeterminate in 77 (10%), with similar percentages in patients with and without dyspnoea. Exercise E\/e\u2032 &amp;gt;15 was found in 37% of patients with abnormal DF, 21% with indeterminate DF, and 6% with normal DF (P &amp;lt; 0.001). Patients with abnormal ExE had more often abnormal resting DF (39% vs. 25%, P = 0.001) and exercise E\/e\u2032 &amp;gt;15 (25% vs. 13%, P &amp;lt; 0.001) than those with normal ExE. During a median follow-up of 1.68 years, there were 132 events. Independent predictors included peak exercise LVEF [hazard ratio (HR) = 0.93, 95% confidence interval (CI) = 0.91\u20130.94, P &amp;lt; 0.001], and exercise E\/e\u2032 (HR= 1.04, 95% CI = 1.01\u20131.07, P = 0.01). Neither resting E\/e\u2032 values nor resting abnormal DF by ASE\/EACVI guidelines, were independent predictors. Annualized event-rates were 43.2% in patients with (+) ExE plus (+) exercise E\/e\u2032, 23.8% in those with (+) ExE and (\u2212) exercise E\/e\u2032, 7.9% in (\u2212) ExE and (+) exercise E\/e\u2032, and 3.6% with both variables normal.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The results of diastolic dysfunction at rest and at exercise were similar between patients with or without dyspnoea referred for ExE, but they were associated with abnormal ExE. Exercise E\/e\u2032 reclassified 21% of patients with indeterminate DF and further predicted outcome on top of ExE results.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jeac039","type":"journal-article","created":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T20:11:57Z","timestamp":1644351117000},"page":"108-118","source":"Crossref","is-referenced-by-count":14,"title":["Additive prognostic and diagnostic value of diastolic exercise parameters in patients referred for exercise echocardiography"],"prefix":"10.1093","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8457-6351","authenticated-orcid":false,"given":"Jes\u00fas","family":"Peteiro","sequence":"first","affiliation":[{"name":"Department of Cardiology, Complejo Hospitalario Universitario de A Coru\u00f1a (CHUAC), CIBERCV, Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a (INIBIC), Universidad de A Coru\u00f1a , As Xubias, 84, 15006 A Coru\u00f1a , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Bouzas-Mosquera","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Complejo Hospitalario Universitario de A Coru\u00f1a (CHUAC), CIBERCV, Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a (INIBIC), Universidad de A Coru\u00f1a , As Xubias, 84, 15006 A Coru\u00f1a , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cayetana","family":"Barbeito-Caama\u00f1o","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Complejo Hospitalario Universitario de A Coru\u00f1a (CHUAC), CIBERCV, Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a (INIBIC), Universidad de A Coru\u00f1a , As Xubias, 84, 15006 A Coru\u00f1a , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esteban","family":"Martin-Alvarez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Complejo Hospitalario Universitario de A Coru\u00f1a (CHUAC), CIBERCV, Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a (INIBIC), Universidad de A Coru\u00f1a , As Xubias, 84, 15006 A Coru\u00f1a , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Borja","family":"Souto-Cainzos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Complejo Hospitalario Universitario de A Coru\u00f1a (CHUAC), CIBERCV, Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a (INIBIC), Universidad de A Coru\u00f1a , As Xubias, 84, 15006 A Coru\u00f1a , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose M","family":"Vazquez-Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Complejo Hospitalario Universitario de A Coru\u00f1a (CHUAC), CIBERCV, Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a (INIBIC), Universidad de A Coru\u00f1a , As Xubias, 84, 15006 A Coru\u00f1a , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,2,17]]},"reference":[{"key":"2022121922324905200_jeac039-B1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.echo.2004.08.033","article-title":"Diastolic stress echocardiography: a novel noninvasive diagnostic test for diastolic dysfunction using supine bicycle exercise Doppler echocardiography","volume":"18","author":"Ha","year":"2005","journal-title":"J Am Soc Echocardiogr"},{"key":"2022121922324905200_jeac039-B2","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.jcmg.2019.01.037","article-title":"Diastolic stress test: invasive and noninvasive testing","volume":"13","author":"Ha","year":"2020","journal-title":"JACC Cardiovasc Imaging"},{"key":"2022121922324905200_jeac039-B3","doi-asserted-by":"crossref","first-page":"3297","DOI":"10.1093\/eurheartj\/ehz641","article-title":"How to diagnose heart failure with preserved ejection 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