Abnormal right ventricular-pulmonary artery coupling with exercise in heart failure with preserved ejection fraction

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F16%3A00060151" target="_blank" >RIV/00023001:_____/16:00060151 - isvavai.cz</a>

Result on the web

<a href="http://eurheartj.oxfordjournals.org/content/ehj/37/43/3293.2.full.pdf" target="_blank" >http://eurheartj.oxfordjournals.org/content/ehj/37/43/3293.2.full.pdf</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/eurheartj/ehw241" target="_blank" >10.1093/eurheartj/ehw241</a>

Result language

angličtina

Original language name

Abnormal right ventricular-pulmonary artery coupling with exercise in heart failure with preserved ejection fraction

Original language description

BACKGROUND: Exercise intolerance is common in people with heart failure and preserved ejection fraction (HFpEF). Right ventricular (RV) dysfunction has been shown at rest in HFpEF but little data are available regarding dynamic RV-pulmonary artery (PA) coupling during exercise. METHODS AND RESULTS: Subjects with HFpEF (n = 50) and controls (n = 24) prospectively underwent invasive cardiopulmonary exercise testing using high-fidelity micromanometer catheters along with simultaneous assessment of RV and left ventricular (LV) mechanics by echocardiography. Compared with controls at rest, subjects with HFpEF displayed preserved RV systolic and diastolic mechanics (RV s' and e'), impaired LV s' and e', higher biventricular filling pressures, and higher pulmonary artery pressures. On exercise, subjects with HFpEF displayed less increase in stroke volume, heart rate, and cardiac output (CO), with blunted increase in CO relative to O2 consumption (VO2). Enhancement in RV systolic and diastolic function on exercise was impaired in HFpEF compared with controls. Exercise-induced PA vasodilation was reduced in HFpEF in correlation with greater venous hypoxia. Elevations in biventricular filling pressures and limitations in CO reserve were strongly correlated with abnormal enhancement in ventricular mechanics in the RV and LV during stress. CONCLUSIONS: In addition to limited LV reserve, patients with HFpEF display impaired RV reserve during exercise that is associated with high filling pressures and inadequate CO responses. These findings highlight the importance of biventricular dysfunction in HFpEF and suggest that novel therapies targeting myocardial reserve in both the left and right heart may be effective to improve clinical status.

Czech name

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Czech description

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Type

J_x - Unclassified - Peer-reviewed scientific article (Jimp, Jsc and Jost)

CEP classification

FA - Cardiovascular diseases including cardio-surgery

OECD FORD branch

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Project

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Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2016

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

European heart journal

ISSN

0195-668X

e-ISSN

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Volume of the periodical

37

Issue of the periodical within the volume

43

Country of publishing house

US - UNITED STATES

Number of pages

9

Pages from-to

3294-3302

UT code for WoS article

000393979500014

EID of the result in the Scopus database

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