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

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

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

Popis výsledku anglicky

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.

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

2022

Kód důvěrnosti údajů

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

Název periodika

JACC. Cardiovascular imaging

ISSN

1936-878X

e-ISSN

1876-7591

Svazek periodika

15

Číslo periodika v rámci svazku

4

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

9

Strana od-do

629-637

Kód UT WoS článku

000840234900011

EID výsledku v databázi Scopus

2-s2.0-85127196406