Heart failure & cardiomyopathiesCross-sectional study
Hypoxaemia in Patients with Heart Failure and Preserved Ejection Fraction
- Cross-sectional study
- invasive cardiopulmonary exercise testing
- sensitivity analysis excluding spirometric abnormalities
Authors' conclusion
Between 10% and 25% of patients with HFpEF display arterial desaturation during exercise that is not ascribable to lung disease. Exertional hypoxaemia is associated with more severe haemodynamic abnormalities and increased mortality.
Study context
- Population
- Patients with HF and preserved ejection fraction (HFpEF) and no coexisting lung disease undergoing invasive cardiopulmonary exercise testing
- Participants
- 539 patients
- Exposure
- Exertional hypoxaemia vs no hypoxaemia
- Hypoxaemian = 136
- No hypoxaemian = 403reference
- Outcome
- Prevalence of exertional arterial hypoxaemia (oxyhaemoglobin saturation <94%)
Main finding
As reported in the abstract
Exertional hypoxaemia
Hypoxaemia
25%
136 of 136
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| All-cause death · 2.8 (IQR 0.7-5.5) years follow-up · adjusted for age, sex and BMI | 2.00 (1.01–3.96) | P = 0.046 | |
| 0.20.5125Hazard ratio (log scale) |
Haemodynamics and gas exchange
- Hypoxaemia: older, more obese; higher cardiac filling and pulmonary vascular pressures, greater alveolar-arterial oxygen difference, increased dead space fraction and greater physiologic shunt vs no hypoxaemia; replicated excluding spirometric abnormalities
- Higher pulmonary arterial and capillary pressures related to lower PaO2, especially during exercise; Body mass index (BMI) not correlated with PaO2
Original publication
Hypoxaemia in Patients with Heart Failure and Preserved Ejection Fraction. Eur J Heart Fail. Published 27 June 2023. doi:10.1002/ejhf.2930
Summarised from the published abstract; every number is checked against it