Subclinical pulmonary congestion and abnormal hemodynamics 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_____%2F22%3A00083449" target="_blank" >RIV/00023001:_____/22:00083449 - isvavai.cz</a>

Result on the web

<a href="https://reader.elsevier.com/reader/sd/pii/S1936878X21007026?token=A5E9526982E5C6243E15F8C24EA46CFC3C68CFF2B7898AEE367EFF404E0EC9274E839CA965CA1E9939762B2CC16FE31A&originRegion=eu-west-1&originCreation=20230103150646" target="_blank" >https://reader.elsevier.com/reader/sd/pii/S1936878X21007026?token=A5E9526982E5C6243E15F8C24EA46CFC3C68CFF2B7898AEE367EFF404E0EC9274E839CA965CA1E9939762B2CC16FE31A&originRegion=eu-west-1&originCreation=20230103150646</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.jcmg.2021.09.017" target="_blank" >10.1016/j.jcmg.2021.09.017</a>

Result language

angličtina

Original language name

Subclinical pulmonary congestion and abnormal hemodynamics in heart failure with preserved ejection fraction

Original language description

OBJECTIVES The authors hypothesized that quantitative computed tomography (QCT) imaging would reveal subclinical increases in lung congestion in patients with heart failure and preserved ejection fraction (HFpEF) and that this would be related to pulmonary vascular hemodynamic abnormalities. BACKGROUND Gross evidence of lung congestion on physical examination, laboratory tests, and radiography is typically absent among compensated ambulatory patients with HFpEF. However, pulmonary gas transfer abnormalities are commonly observed and associated with poor outcomes. METHODS Patients referred for invasive hemodynamic exercise testing who had undergone chest computed tomography imaging within 1 month were identified (N = 137). A novel artificial intelligence QCT algorithm was used to measure pulmonary fluid content. RESULTS Compared with control subjects with noncardiac dyspnea, patients with HFpEF displayed increased mean lung density (-758 HU [-793, -709 HU] vs -787 HU [-828, -747 HU]; P = 0.002) and a higher ratio of extravascular lung water to total lung volume (EVLWV/TLV) (1.25 [0.80, 1.76] vs 0.66 [0.01, 1.03]; P &lt; 0.0001) by QCT imaging, indicating greater lung congestion. EVLWV/TLV was directly correlated with pulmonary vascular pressures at rest, with stronger correlations observed during exercise. Patients with increasing tertiles of EVLWV/TLV demonstrated higher mean pulmonary artery pressures at rest (34 +/- 11 mm Hg vs 39 +/- 14 mm Hg vs 45 +/- 17 mm Hg; P = 0.0003) and during exercise (55 +/- 17 mm Hg vs 59 +/- 17 mm Hg vs 69 +/- 22 mm Hg; P = 0.0003). CONCLUSIONS QCT imaging identifies subclinical lung congestion in HFpEF that is not clinically apparent but is related to abnormalities in pulmonary vascular hemodynamics. These data provide new insight into the long-term effects of altered hemodynamics on pulmonary structure and function in HFpEF. (C) 2022 by the American College of Cardiology Foundation.

Czech name

—

Czech description

—

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

—

Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2022

Confidentiality

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

Name of the periodical

JACC. Cardiovascular imaging

ISSN

1936-878X

e-ISSN

1876-7591

Volume of the periodical

15

Issue of the periodical within the volume

4

Country of publishing house

US - UNITED STATES

Number of pages

9

Pages from-to

629-637

UT code for WoS article

000840234900011

EID of the result in the Scopus database

2-s2.0-85127196406