Doppler Mitral Inflow Variables Time Course After Treadmill Stress Echo with and Without Ischemic Response
Abstract 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 (∆E) [34.2 vs. 24.2, p = 0.024] and E-wave deceleration rate (∆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 (∆A) did not differ [7.9 vs. 15.0, p = 0.082]. The correlations between Doppler variables and IR, TIME, and TIME*IR interaction were analyzed. We observed a significant interaction between TIME and IR regarding ∆E and ∆DR. The differences in the regression line slopes of time courses for ∆E and ∆DR based on IR were significant: ∆E (–0.09 vs. –8.17, p = 0.037) and ∆DR (11.23 vs. –82.60, p = 0.022). Main findings: 1. Time courses after exercise of ∆E and ∆DR in subjects with and without IR were different. 2. ∆E and ∆DR did not differ between subjects with and without IR at exercise cessation (TIME = 0). 3. The simple main effect of ischemia on ∆E and ∆DR was significant at TIME of ≥3 min. Divergent time courses of ∆E and ∆DR after exercise might be promising for detecting diastolic dysfunction caused by ischemia.