Heart failure & cardiomyopathies
Deep Phenotype Characterization of Hypertensive Response to Exercise: Implications on Functional Capacity and Prognosis Across the Heart Failure Spectrum
Authors' conclusion
A steeper SBP/workload slope is associated with impaired functional capacity across the HF spectrum and could be a more sensitive predictor of adverse events than absolute SBP values, mainly in patients in Stages A-B and HFpEF.
Study context
- Population
- Patients with heart failure (HF) Stage C, subjects at risk of HF (Stages A-B) and healthy controls undergoing combined cardiopulmonary exercise stress echocardiography369 with HF Stage C
- Participants
- 143 / 226 / 201 / 58
- Exposure
- Hypertensive response to exercise (HRE) vs no HRE across the HF spectrum
- HFpEFn = 143
- HFrEFn = 226
- Stages A-Bn = 201
- Controlsn = 58reference
- Outcome
- SBP/workload slope during exercise and its haemodynamic and prognostic correlates (HRE)
Main finding
As reported in the abstract
SBP/workload slope (age- and sex-adjusted)
HFrEF
0.47
range 0.30–0.63
Controls
0.43
range 0.35–0.57
Stages A-B
0.61
range 0.47–0.75
HFpEF
0.63
range 0.42–0.86
- Slope 39% steeper in women than men
- P < 0.0001
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Death or CV hospitalization, HREvs no HRE · median follow-up 16 monthsIndependent association; rest and peak SBP not associated | 2.05 (1.81–5.18) | |
| 0.20.5125Hazard ratio (log scale) |
- Death or CV hospitalization, HRE vs no HRE — Worse survival with HRE in Stages A-B
- p = 0.005
- Death or CV hospitalization, HRE vs no HRE — Worse survival with HRE in HFpEF
- p < 0.001
Death or CV hospitalization, HRE vs no HRE · median follow-up 16 months
- No worse survival with HRE in HFrEF
Peak oxygen consumption and peripheral oxygen extraction
- Significantly lower in patients with HRE
Original publication
Deep Phenotype Characterization of Hypertensive Response to Exercise: Implications on Functional Capacity and Prognosis Across the Heart Failure Spectrum. Eur J Heart Fail. Published 29 March 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →