Heart failure & cardiomyopathies
Incremental diagnostic value of post-exercise lung congestion in heart failure with preserved ejection fraction
Authors' conclusion
Exercise EVLW was most prominent early during the recovery period; this may be the optimal timeframe for imaging ultrasound B-lines.
Study context
- Population
- Patients with heart failure with preserved ejection fraction (HFpEF) and controls without HF undergoing exercise stress echocardiography with lung ultrasound (LUS) and expired gas analysis
- Participants
- 134 vs 121
- Comparison
- HFpEF vs controls without HF
- HFpEFn = 134
- Controlsn = 121reference
- Outcome
- Dynamic changes in ultrasound B-lines (exercise EVLW) during exercise to identify the optimal timeframe for HFpEF diagnosis
Performance
As reported in the abstract
Exercise EVLW (B-lines newly developed or increased during exercise)
- Exercise extravascular lung water (EVLW) most prominent during the recovery period in HFpEF
- In controls, EVLW prevalence did not increase from peak exercise to recovery
- Increase in B-lines from rest to recovery gave incremental diagnostic value for HFpEF over the H2FPEF score and resting left atrial reservoir strain
Further findings
E/e' ratio in HFpEF
- E/e' peaked at maximal exercise and immediately decreased during recovery
Correlates of exercise EVLW at peak exercise
- Associated with higher E/e' and pulmonary artery pressure, lower RV systolic function, and elevated VE vs. VCO2 slope
Original publication
Incremental diagnostic value of post-exercise lung congestion in heart failure with preserved ejection fraction. Eur Heart J Cardiovasc Imaging. Published 24 January 2023. doi:10.
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