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

Kód výsledku v 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>

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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

Název v anglickém jazyce

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

Popis výsledku anglicky

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

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

<a href="/cs/project/NV17-28784A" target="_blank" >NV17-28784A: Mechanismy dysfunkce pravé komory u chronického srdečního selhání</a><br>

Návaznosti

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

Rok uplatnění

2018

Kód důvěrnosti údajů

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

Název periodika

Journal of the American College of Cardiology

ISSN

0735-1097

e-ISSN

—

Svazek periodika

72

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

12

Strana od-do

29-40

Kód UT WoS článku

000436432000005

EID výsledku v databázi Scopus

2-s2.0-85048632528