Heart failure & cardiomyopathies
Disproportionate Exercise-Induced Pulmonary Hypertension in Relation to Cardiac Output in Heart Failure with Preserved Ejection Fraction: A Non-Invasive Echocardiographic Study
Authors' conclusion
Patients with HFpEF and DEi-PH demonstrated distinct pathophysiologic features that become apparent only during exercise.
Study context
- Population
- Patients with heart failure with preserved ejection fraction (HFpEF) and controls undergoing ergometry exercise stress echocardiography166 HFpEF
- Participants
- 345 patients
- Exposure
- HFpEF with DEi-PH vs HFpEF without DEi-PH vs controls
- HFpEF with DEi-PHn = 83
- HFpEF without DEi-PHn = 83reference
- Controlsn = 179
- Outcome
- Exercise pathophysiology
- Follow-up
- Peak exercise
Methodological detailsexercise stress echocardiography with expired gas analysis
- Exercise stress echocardiography with expired gas analysis
Main finding
As reported in the abstract
- At rest, no differences in right ventricular (RV) function or pulmonary hypertension (PH) severity between HFpEF with and without DEi-PH
- HFpEF with DEi-PH: lower peak oxygen consumption, depressed RV systolic function, impaired RV-pulmonary artery coupling, limited CO augmentation, more right-sided congestion and worse ventilatory efficiency at peak exercise vs controls and HFpEF without DEi-PH
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| All-cause mortality or HF events (composite)HFpEF with DEi-PH vs HFpEF without DEi-PH · higher rates with DEi-PH | P = 0.0002 |
Original publication
Disproportionate Exercise-Induced Pulmonary Hypertension in Relation to Cardiac Output in Heart Failure with Preserved Ejection Fraction: A Non-Invasive Echocardiographic Study. Eur J Heart Fail. Published 13 March 2023. doi:10.
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