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

Kód výsledku v 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>

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

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

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2018

Kód důvěrnosti údajů

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

Název periodika

JACC. Heart failure

ISSN

2213-1779

e-ISSN

—

Svazek periodika

6

Číslo periodika v rámci svazku

8

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

11

Strana od-do

665-675

Kód UT WoS článku

000440382300007

EID výsledku v databázi Scopus

2-s2.0-85047293128