Left and right heart Doppler stress echo in congestive heart failure

Doppler echocardiographic assessment of the left and right ventricular function at rest, during and 6 minutes after submaximal exercise was performed in 60 patients with a mean age of 43 +/- 11 years suffering from heart failure classified stage I-III according to the NYHA-criteria and 10 volunteers with a mean age of 36 +/- 9 years who served as a control group. At mitral (m) and tricuspid (t) valve early diastolic peak-flow velocity (VEm, VEt), atrial peak-flow velocity (VAm, VAt), speed-time integrals (Em, Et, Am, At) and the ratios (VE/VAm, VE/VAt, E/Am, E/At) were determined. The left ventricular end-diastolic diameter (LVEDD) and the right ventricular outflow tract (RVOT) were measured in addition. The left ventricular ejection fraction (LVEF) was decreased to < 36% in 9 patients (group 1). In 51 individuals LVEF was found to be > 35% but < 50% or LVEF was shown to be > 50% but VE/VAm-ratio was found to be < 1 (group 2). Out of all the determined parameters, VE/VAt, VEt and VAm during exercise were found to be the most sensitive parameters for the detection of early to advanced grade left heart failure.