pressure vs. diastolic reserve

Aims The diastolic stress test (DST) may facilitate the attribution of exertional dyspnoea to cardiac and non-cardiac dis-eases. However, there is currently no consensus as to the optimal marker of exertional diastolic dysfunction (DD)— the main alternatives being estimated left ventricular (LV) filling pressure (exercise E/e′) and diastolic functional reserve (DFRI). We sought to compare the correlates of these parameters. Methods and results DST was performed by adding the measurement of the transmitral (E) and annular (e′) velocities to standard exercise echo in 559 consecutive patients without significant rest or exercise mitral regurgitation. Exertional DD was separ-ately defined by post-stress E/e ′.13 or DFRI,13.5. Logistic regression was used to identify the correlates of ab-normal responses and linear regression was used to identify the contribution of both to exercise capacity. Abnormal exercise E/e ′ (n 112, 20%) and DFRI (n 317, 57%) were modestly associated (k 0.35, P, 0.0001). In a linear regression, abnormal exercise E/e ′ (b 20.19, P, 0.001) and DFRI (b 20.15, P 0.001) were associate