AQUI >>>>>>>>>>>>>Conclusion: The assessment of longitudinal systolic and diastolic LV and RV functions is valuable during a sub-maximal exercise stress echocardiography to confirm the heart dysfunction related to the HFPEF symptoms. It might be used as a diagnostic test for difficult clinical situations.
Reparem no protocolo simples:
Sub-maximal exercise test
Following clinical examination, arterial blood pressure measurement (Dinamap Procare Auscultatory 100), 12-lead electrocardiogram, and resting transthoracic echocardiography (Vivid 7, General Electric Healthcare, Horten, Norway), the patients underwent a standard supine exercise echocardiography on a tilting table with an electromagnetic cycle ergometer (Ergometrics). Exercise testing was started at an initial workload of 30W, the workload being increased by increments of 20 W every 2min. The pedaling rate was 60 rpm, the electrocardiogram was recorded continuously, and blood pressure was measured every 2min both on exercise and during recovery from exercise. Exercise testing was interrupted promptly in the case of typical chest pain, limiting breathlessness, dizziness, muscular exhaustion, severe hypertension (systolic blood pressure of >=250 mmHg), or significant ventricular arrhythmia. Blood pressure, ECG, and echocardiographic images were acquired at rest and for a heart rate (HR, 100–120/min) and at least five consecutive beats were recorded. The test should have been considered abnormal if the patient presented one or more of the following criteria: angina, evidence of shortness of breath at low workload level (=2 mm ST segment depression in comparison to baseline levels, rise in systolic blood during exercise <20 mmHg, or a fall in blood pressure and complex ventricular arrhythmias. The exercise duration was planned to be (8–10) min for every patient.