Myocardial Injury and Cardiac Reserve in Patients With Heart Failure and Preserved Ejection Fraction

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F18%3A00077037" target="_blank" >RIV/00023001:_____/18:00077037 - isvavai.cz</a>

Result on the web

<a href="https://www.sciencedirect.com/science/article/pii/S073510971834659X?via%3Dihub" target="_blank" >https://www.sciencedirect.com/science/article/pii/S073510971834659X?via%3Dihub</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.jacc.2018.04.039" target="_blank" >10.1016/j.jacc.2018.04.039</a>

Result language

angličtina

Original language name

Myocardial Injury and Cardiac Reserve in Patients With Heart Failure and Preserved Ejection Fraction

Original language description

Cardiac reserve is depressed in patients with heart failure and preserved ejection fraction (HFpEF). Markers of cardiomyocyte injury, central hemodynamics, ventricular function, and determinants of cardiac oxygen supply-demand balance were measured. RESULTS Compared with control subjects, troponins were more than 2-fold higher in subjects with HFpEF at rest and during exercise (p &lt; 0.0001). Troponin levels were directly correlated with left ventricular (LV) filling pressures (r = 0.52; p &lt; 0.0001) and diastolic dysfunction (r = -0.43; p = 0.002). Although myocardial oxygen demand was similar, myocardial oxygen supply was depressed in HFpEF, particularly during exercise (coronary perfusion pressuretime integral; 44 +/- 9 mmHg x s x min(-1) x l x dl(-1) vs. 30 +/- 9 mmHg x s x min(-1) x l x dl(-1); p &lt; 0.0001), and reduced indices of supply were correlated with greater myocyte injury during exercise (r = -0.44; p = 0.0008). Elevation in troponin with exercise was directly correlated with an inability to augment LV diastolic (r = -0.40; p = 0.02) and systolic reserve (r = -0.57; p = 0.0003), greater increases in LV filling pressures (r = 0.55; p &lt; 0.0001), blunted cardiac output response (r = -0.44; p = 0.002), and more severely depressed aerobic capacity in HFpEF. CONCLUSIONS Limitations in LV functional reserve and the hemodynamic derangements that develop secondary to these limitations during exercise in HFpEF are correlated with the severity of cardiac injury, assessed by plasma levels of troponin T. Further study is warranted to determine the mechanisms causing myocyte injury in HFpEF and the potential role of ischemia, and to identify and test novel interventions targeted to these mechanisms. EXEC [Study of Exercise and Heart Function in Patients With Heart Failure and Pulmonary Vascular Disease]; (C) 2018 by the American College of Cardiology Foundation

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

<a href="/en/project/NV17-28784A" target="_blank" >NV17-28784A: Mechanisms of right ventricular dysfunction in chronic heart failure</a><br>

Continuities

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Publication year

2018

Confidentiality

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

Name of the periodical

Journal of the American College of Cardiology

ISSN

0735-1097

e-ISSN

—

Volume of the periodical

72

Issue of the periodical within the volume

1

Country of publishing house

US - UNITED STATES

Number of pages

12

Pages from-to

29-40

UT code for WoS article

000436432000005

EID of the result in the Scopus database

2-s2.0-85048632528