Hemodynamic correlates and diagnostic role of cardiopulmonary exercise testing 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_____%2F18%3A00077077" target="_blank" >RIV/00023001:_____/18:00077077 - isvavai.cz</a>

Result on the web

<a href="https://www.sciencedirect.com/science/article/pii/S2213177918302038" target="_blank" >https://www.sciencedirect.com/science/article/pii/S2213177918302038</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.jchf.2018.03.003" target="_blank" >10.1016/j.jchf.2018.03.003</a>

Result language

angličtina

Original language name

Hemodynamic correlates and diagnostic role of cardiopulmonary exercise testing in heart failure with preserved ejection fraction

Original language description

OBJECTIVES This study sought to define the invasive hemodynamic correlates of peak oxygen consumption (Vo(2)) in both supine and upright exercise in heart failure with preserved ejection fraction (HFpEF) and evaluate its diagnostic role as a method to discriminate HFpEF from noncardiac etiologies of dyspnea (NCD). BACKGROUND Peak Vo(2) is depressed in patients with HFpEF. The hemodynamic correlates of reduced peak Vo(2) and its role in the clinical evaluation of HFpEF are unclear. METHODS Consecutive patients with dyspnea and normal EF (N = 206) undergoing both noninvasive upright and invasive supine cardiopulmonary exercise testing were examined. Patients with invasively verified HFpEF were compared with those with NCD. RESULTS Compared with NCD (n = 72), HFpEF patients (n = 134) displayed lower peak Vo(2) during upright and supine exercise. Left heart filling pressures during exercise were inversely correlated with peak Vo(2) in HFpEF, even after accounting for known determinants of O-2 transport according to the Fick principle. Very low upright peak Vo(2) (&lt; 14 ml/kg/min) discriminated HFpEF from NCD with excellent specificity (91%) but poor sensitivity (50%). Preserved peak Vo(2) (&gt; 20 ml/kg/min) excluded HFpEF with high sensitivity (90%) but had poor specificity (49%). Intermediate peak Vo(2) cutoff points were associated with substantial overlap between cases and NCD. CONCLUSIONS Elevated cardiac filling pressure during exercise is independently correlated with reduced exercise capacity in HFpEF, irrespective of body position, emphasizing its importance as a novel therapeutic target. Noninvasive cardiopulmonary testing discriminates HFpEF and NCD at high and low values, but additional testing is required for patients with intermediate peak Vo(2). (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

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OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2018

Confidentiality

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

Name of the periodical

JACC. Heart failure

ISSN

2213-1779

e-ISSN

—

Volume of the periodical

6

Issue of the periodical within the volume

8

Country of publishing house

US - UNITED STATES

Number of pages

11

Pages from-to

665-675

UT code for WoS article

000440382300007

EID of the result in the Scopus database

2-s2.0-85047293128