Heart failure & cardiomyopathies
Ventricular Stiffening and Chamber Contracture in Heart Failure with Higher Ejection Fraction
Authors' conclusion
Most pathophysiologic differences in patients with HFpEF and higher EF are related to smaller heart size, increased LV diastolic stiffness, and leftward shift in the EDPVR.
Study context
- Population
- Patients with heart failure and preserved ejection fraction (HFpEF) undergoing comprehensive echocardiography and invasive cardiopulmonary exercise testing621 HFpEF
- Participants
- 319 / 302 / 149
- Exposure
- HFpEF≥65% vs HFpEF<65% vs age-matched controls
- HFpEF<65%n = 319reference
- HFpEF≥65%n = 302
- Controlsn = 149
Methodological detailsinvasive cardiopulmonary exercise testing, community-based sensitivity cohort
- Invasive cardiopulmonary exercise testing
- Community-based sensitivity cohort
Main finding
As reported in the abstract
- HFpEF≥65% had smaller left ventricular (LV) end-diastolic volume than HFpEF<65%
- LV systolic function (preload recruitable stroke work, stroke work/end-diastolic volume) similarly impaired
- HFpEF≥65%: End-diastolic pressure-volume relationship (EDPVR) shifted leftward, with increased LV diastolic stiffness constant β, in invasive and community-based cohorts
- Filling and pulmonary artery pressures at rest and exercise similarly abnormal in all ejection fraction (EF) subgroups
Observational data: associations, not effects.
Further findings
Events
| Outcome | HFpEF | Healthy controls |
|---|---|---|
| Sensitivity analysis, community-based cohortCounts are cohort n | 244 | 617 |
EDPVR by EF threshold 57%
- HFpEF≥57% leftward shifted EDPVR; HFpEF<57% rightward shifted EDPVR, more typical of HFrEF
Original publication
Ventricular Stiffening and Chamber Contracture in Heart Failure with Higher Ejection Fraction. Eur J Heart Fail. Published 12 April 2023. doi:10.
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