Valvular & structural heart disease
Haemodynamic and Metabolic Phenotyping of Patients with Aortic Stenosis and Preserved Ejection Fraction: A Specific Phenotype of Heart Failure with Preserved Ejection Fraction?
Authors' conclusion
Functional capacity is similarly impaired in ASpEF and HFpEF due to both peripheral and central components.
Study context
- Population
- Patients with heart failure with preserved ejection fraction (HFpEF) or degenerative moderate-to-severe AS with preserved EF, and healthy controls351/364 (96%) performed exercise test
- Participants
- 148 / 150 / 66
- Exposure
- ASpEF vs HFpEF vs healthy controls
- HFpEFn = 148
- ASpEFn = 150
- Controlsn = 66reference
- Outcome
- Exercise haemodynamics and metabolism (peak VO2, peak cardiac output, peak arteriovenous O2 difference)
Methodological detailsage- and sex-matched healthy controls, Cardiac computed tomography (CT) in ASpEF patients eligible for TAVR (n = 125)
- Age- and sex-matched healthy controls
- Cardiac CT in ASpEF patients eligible for TAVR (n = 125)
Main finding
As reported in the abstract
- HFpEF and ASpEF both had significantly lower peak VO2, peak cardiac output and peak arteriovenous O2 difference vs controls
- all p < 0.01
- ASpEF showed several extravalvular abnormalities at rest and during exercise, similar to HFpEF, vs controls
- all p < 0.01
Observational data: associations, not effects.
Further findings
- AS phenotype in ASpEF
- 134/150, 89% · Severe high-gradient AS · Normal-flow, low-gradient 6/150 (4%) · Low-flow, low-gradient 10/150 (7%)
Epicardial adipose tissue (EAT) thickness
- EAT thickness significantly greater in ASpEF than HFpEF
- EAT inversely correlated with peak VO2 in all groups
- In ASpEF, EAT directly related to echocardiographic disease severity and CT aortic valve calcium burden
Demographics and biohumoral profiles
- Similar in HFpEF and ASpEF
Original publication
Haemodynamic and Metabolic Phenotyping of Patients with Aortic Stenosis and Preserved Ejection Fraction: A Specific Phenotype of Heart Failure with Preserved Ejection Fraction? Eur J Heart Fail. Published 14 September 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →