{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:24:40Z","timestamp":1740137080867,"version":"3.37.3"},"reference-count":35,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2017,7,6]],"date-time":"2017-07-06T00:00:00Z","timestamp":1499299200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2017,8]]},"abstract":"Background<\/jats:title>Left ventricular (LV<\/jats:styled-content>) contractile reserve assessed using imaging and cardiopulmonary exercise testing (CPX<\/jats:styled-content>) has been shown to predict outcome in patients with dilated cardiomyopathy (DCM<\/jats:styled-content>). Few clinical studies have, however, analyzed the relationship between them.<\/jats:p><\/jats:sec>Methods<\/jats:title>A cohort of 75 ambulatory patients with DCM<\/jats:styled-content> underwent stress treadmill echocardiography with CPX<\/jats:styled-content>. LV<\/jats:styled-content> contractile reserve was calculated as absolute change (\u0394LVEF<\/jats:styled-content>=LVEF<\/jats:styled-content>peak<\/jats:sub>\u2212LVEF<\/jats:styled-content>rest<\/jats:sub>) and percent change (%LVEF<\/jats:styled-content>=[(LVEF<\/jats:styled-content>peak<\/jats:sub>\u2212LVEF<\/jats:styled-content>rest<\/jats:sub>)\/LVEF<\/jats:styled-content>peak)<\/jats:sub>]\u00d7100) in LVEF<\/jats:styled-content>, circumferential and longitudinal strain (LS<\/jats:styled-content>). Exercise capacity was measured as peak oxygen uptake (peak VO<\/jats:styled-content>2<\/jats:sub>) and ventilatory efficiency as the slope of minute ventilation to CO<\/jats:styled-content>2<\/jats:sub> production (VE<\/jats:styled-content>\/VCO<\/jats:styled-content>2<\/jats:sub> slope). Values of contractile reserve were compared to matched controls. We also explored which metric of ventricular response (absolute or percent change) was less dependent on baseline LV<\/jats:styled-content> function.<\/jats:p><\/jats:sec>Results<\/jats:title>Patients with DCM<\/jats:styled-content> had a mean age, rest and peak LVEF<\/jats:styled-content> of 44\u00b110\u00a0years, 42\u00b110% and 50\u00b112%, respectively. Among parameters of contractile reserve, peak cardiac output was the strongest parameter associated with peak VO<\/jats:styled-content>2<\/jats:sub> (r<\/jats:italic>=.63, P<\/jats:italic><.001). Along with age, sex, and BMI<\/jats:styled-content>, it explained more than 70% of the variance in peak VO<\/jats:styled-content>2<\/jats:sub>. In contrast, LVEF<\/jats:styled-content> and LS<\/jats:styled-content> were only weakly related to peak VO<\/jats:styled-content>2<\/jats:sub>. With regard to ventilatory efficiency, the strongest parameter that emerged was right atrial volume index (r<\/jats:italic>=.36, P<\/jats:italic><.001). Percent change in LVEF<\/jats:styled-content> was more independent of baseline function than absolute change.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Echocardiographic contractile reserve and CPX<\/jats:styled-content> provide complementary information. Percent change in contractile reserve was most independent of baseline function, therefore may be preferred when analyzing the ventricular response to exercise.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.13623","type":"journal-article","created":{"date-parts":[[2017,7,6]],"date-time":"2017-07-06T05:22:36Z","timestamp":1499318556000},"page":"1179-1186","source":"Crossref","is-referenced-by-count":9,"title":["Contractile reserve and cardiopulmonary exercise parameters in patients with dilated cardiomyopathy, the two dimensions of exercise testing"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9503-6660","authenticated-orcid":false,"given":"Kegan J.","family":"Moneghetti","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine Stanford University School of Medicine Stanford CA USA"},{"name":"Stanford Cardiovascular Institute Stanford CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8304-8194","authenticated-orcid":false,"given":"Yukari","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Stanford University School of Medicine Stanford CA USA"},{"name":"Stanford Cardiovascular Institute Stanford CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey W.","family":"Christle","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Stanford University School of Medicine Stanford CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miyuki","family":"Ariyama","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Stanford University School of Medicine Stanford CA USA"},{"name":"Stanford Cardiovascular Institute Stanford CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bojan","family":"Vrtovec","sequence":"additional","affiliation":[{"name":"Stanford Cardiovascular Institute Stanford CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatiana","family":"Kouznetsova","sequence":"additional","affiliation":[{"name":"Stanford Cardiovascular Institute Stanford CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Wilson","sequence":"additional","affiliation":[{"name":"Cardiology Department St Vincent's Health Melbourne Vic. 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