Cohort study
Heart failure with preserved ejection fraction: relevance of a dedicated dyspnoea clinic
- Descriptive cohort study
- consecutive patients
- single dedicated dyspnoea clinic
Authors' conclusion
Holistic workup of HFpEF patients within a multidisciplinary, dedicated dyspnoea clinic, including systematic implementation of CPETecho reveals various haemodynamic/metabolic alterations, leading to further diagnostic testing and potential treatment changes in the majority of cases.
Study context
- Population
- Patients with heart failure with preserved ejection fraction (HFpEF) (H2FPEF score ≥6 or HFA-PEFF score ≥5) referred to a dedicated dyspnoea clinic with standardized workup including CPETecho
- Participants
- 297 consecutive patients
- Outcome
- Haemodynamic and metabolic alterations revealed by CPETecho
Main finding
As reported in the abstract
Haemodynamic/metabolic alterations on CPETecho
- Alterations per patient (median)
- four
- Impaired stroke volume reserve
- 73%
- Impaired chronotropic reserve
- 72%
- Exercise pulmonary hypertension
- 65%
- Impaired diastolic reserve
- 64%
- Impaired peripheral oxygen extraction
- 40%
- Ventilatory limitation
- 39%
Observational data: associations, not effects.
Further findings
Further diagnostic examinations recommended
- Patients with further examinations recommended
- 267 (90%)
- Examinations recommended
- 575
- Tests per patient (median)
- two
- CMR, coronary or amyloidosis workup, ventilation-perfusion scanning, pulmonology referral: each recommended
- approximately one out of three patients
CV drug optimizations
- Patients with drug optimization
- 293 (99%)
- Drug optimizations performed
- 929
- Modifications per patient (median)
- 3
CV interventions
- Patients with interventions
- 110 (37%)
- Interventions performed (ablation most frequent)
- 132
Original publication
Heart failure with preserved ejection fraction: relevance of a dedicated dyspnoea clinic. Eur Heart J. Published 16 March 2023. doi:10.1093/eurheartj/ehad141
Summarised from the published abstract; every number is checked against it