Heart failure & cardiomyopathiesCohort study

Shedding Light on Latent Pulmonary Vascular Disease in Heart Failure With Preserved Ejection Fraction

JACC Heart FailPublished

  • Retrospective cohort study

Authors' conclusion

The results suggest that when CO is measured by direct Fick, few HFpEF patients have isolated latent PVD (ie, normal PVR at rest, becoming abnormal during exercise). HFpEF-latentPVD patients present with CO limitation to exercise, associated with dynamic tricuspid regurgitation, altered ventilatory control, and pulmonary vascular hyperreactivity, portending a poor prognosis.

Study context

Population
Heart failure with preserved ejection fraction (HFpEF) patients who underwent supine exercise right heart catheterization with CO by direct Fick, 2016–2021
Participants
86 patients
Exposure
HFpEF-latentPVD vs HFpEF control

Main finding

As reported in the abstract

Prevalence of HFpEF-latentPVD (exercise PVR >1.74 WU) among HFpEF patients

HFpEF patients qualifying as HFpEF-latentPVD

21%

HFpEF-latentPVD with pulmonary vascular resistance (PVR) >2 WU at rest

78%

Observational data: associations, not effects.

Further findings

Event-free survival

Reduced in HFpEF-latentPVD
P < 0.05

Baseline characteristics

HFpEF-latentPVD older, higher pretest probability of HFpEF, more AF and at least moderate tricuspid regurgitation
P < 0.05

Original publication

Shedding Light on Latent Pulmonary Vascular Disease in Heart Failure With Preserved Ejection Fraction. JACC Heart Fail. Published 26 April 2023. doi:10.1016/j.jchf.2023.03.003

Summarised from the published abstract; every number is checked against it