Heart failure & cardiomyopathies
Increased Chamber Resting Tone Is a Key Determinant of Left Ventricular Diastolic Dysfunction
Authors' conclusion
Augmented RT is the major cause of LV diastolic chamber dysfunction in hypertrophic cardiomyopathy and HF with preserved ejection fraction. RT transients determine diastolic pressures, pulmonary pressures, and functional capacity to a greater extent than relaxation and stiffness abnormalities.
Study context
- Population
- Patients with hypertrophic cardiomyopathy or HFpEF, and control subjects, undergoing cardiopulmonary exercise
- Participants
- 20 / 17 / 35
- Comparison
- Chamber resting tone (RT) in HCM vs controls vs HFpEF, at rest and with exercise
- Hypertrophic cardiomyopathyn = 20
- Controln = 17reference
- Heart failure (HF) with preserved ejection fractionn = 35
- Outcome
- Chamber resting tone (RT)
Methodological detailsinvasive pressure-volume monitoring during cardiopulmonary exercise, in silico validation
- Invasive pressure-volume monitoring during cardiopulmonary exercise
- In silico validation
Main finding
As reported in the abstract
Chamber RT
| Group | Value | RT with exercise |
|---|---|---|
| Hypertrophic cardiomyopathy | estimated marginal mean 3.4 (95% CI 0.4–6.4) mm Hg | 18.5 (15.5-21.5) mm Hg |
| Controls | 0.0 mm Hg | |
| HFpEF | 1.2 (95% CI 0.3–2.8) mm Hg |
Value
Hypertrophic cardiomyopathyestimated marginal mean 3.4 (95% CI 0.4–6.4) mm Hg
Controls0.0 mm Hg
HFpEF1.2 (95% CI 0.3–2.8) mm Hg
RT with exercise
Hypertrophic cardiomyopathy18.5 (15.5-21.5) mm Hg
Controls— not stated in the abstract
HFpEF— not stated in the abstract
- HCM: RT increase with exercise
- P < 0.001
- HCM: share of end-diastolic pressure due to RT at peak exercise
- 64% (53%-76%)
Further findings
Correlation of RT with NT-proBNP (HCM)
- R
- 0.57
- P
- P = 0.02
Correlation of RT with pulmonary wedge pressure (different slopes at rest and exercise)
- R2
- 0.49
- P
- P < 0.001
In silico: RT vs twitch-independent myofilament tension (loss of cMyBP-C)
- R
- 0.997
Original publication
Increased Chamber Resting Tone Is a Key Determinant of Left Ventricular Diastolic Dysfunction. Circ Heart Fail. Published 19 December 2023. doi:10.
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