Abnormal right ventricular-pulmonary artery coupling with exercise in heart failure with preserved ejection fraction
Authors' conclusion
In addition to limited LV reserve, patients with HFpEF display impaired RV reserve during exercise that is associated with high filling pressures and inadequate CO responses.
Study context
- Population
- Subjects with heart failure and preserved ejection fraction (HFpEF) and controls undergoing invasive cardiopulmonary exercise testing
- Participants
- 50 vs 24
- Comparison
- HFpEF vs controls
- HFpEFn = 50
- Controlsn = 24reference
- Outcome
- Dynamic RV-PA coupling and RV/LV mechanics during exercise
Methodological detailsinvasive cardiopulmonary exercise testing, simultaneous echocardiography
- Invasive cardiopulmonary exercise testing
- Simultaneous echocardiography
Main finding
As reported in the abstract
- At rest, HFpEF: preserved right ventricular (RV) s' and e', impaired left ventricular (LV) s' and e', higher biventricular filling pressures and higher PA pressures vs controls
- On exercise, HFpEF: less increase in stroke volume, heart rate and cardiac output (CO), blunted increase in CO relative to VO2
- Enhancement in RV systolic and diastolic function on exercise impaired in HFpEF vs controls
- Exercise-induced PA vasodilation reduced in HFpEF, correlated with greater venous hypoxia
- Elevated biventricular filling pressures and limited CO reserve strongly correlated with abnormal enhancement in RV and LV mechanics during stress
Observational data: associations, not effects.
Original publication
Abnormal right ventricular-pulmonary artery coupling with exercise in heart failure with preserved ejection fraction. Eur Heart J. Published 26 June 2016. doi:10.
Summarised from the published abstract; every number is checked against it