Heart failure & cardiomyopathies
Dynamic Aspects of Ventricular Interaction During Exercise in Heart Failure with Preserved Ejection Fraction (HFpEF) and in Pre-Capillary Pulmonary Hypertension
Authors' conclusion
Exercise amplifies adverse right-left ventricular interactions in CTEPH, while a more moderate effect is observed in isolated post-capillary HFpEF.
Study context
- Population
- Patients with HFpEF or chronic thromboembolic pulmonary hypertension (CTEPH) and healthy controls undergoing exercise CMR
- Participants
- 46 patients
- Comparison
- HFpEF and CTEPH vs healthy controls
- Controlsn = 10reference
- CTEPHn = 19
- HFpEFn = 17
- Outcome
- Ventricular interaction by septal curvature (SC) of a mid-ventricular short-axis slice at end-diastole, end-systole and early-diastole, in expiration and inspiration
- Follow-up
- Rest and exercise
Main finding
As reported in the abstract
Ventricular interaction (SC) with exercise
- Exercise amplified ventricular interaction in CTEPH and to a lesser extent in HFpEF (decrease in septal curvature (SC) with exercise)
- P < 0.05
- Adverse interaction most profound in early-diastole and most pronounced in CTEPH (interaction group * exercise)
- P < 0.05
- Disproportionate increase in RV afterload in CTEPH (vs both controls and HFpEF)
- P < 0.05
- Diastolic pericardial restraint during exercise (interaction group * exercise)
- P < 0.001
- Inspiration enhanced diastolic interdependence in CTEPH and HFpEF (vs expiration)
- P < 0.05
- SC strongly correlated with RV volumes and pulmonary artery pressures at rest and during exercise
- all P < 0.05
Original publication
Dynamic Aspects of Ventricular Interaction During Exercise in HFpEF and in Pre-Capillary Pulmonary Hypertension. ESC Heart Fail. Published 24 November 2022. doi:10.
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