Resting and exercise haemodynamic characteristics of patients with advanced heart failure and preserved ejection fraction.

Autor: Deis T; Department of Cardiology, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, Copenhagen, 2100, Denmark., Wolsk E; Department of Cardiology, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, Copenhagen, 2100, Denmark.; Department of Cardiology, Herlev-Gentofte Hospital, Hellerup, Denmark., Mujkanovic J; Department of Cardiology, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, Copenhagen, 2100, Denmark., Komtebedde J; Corvia Medical, Boston, MA, USA., Burkhoff D; Cardiovascular Research Foundation, New York, NY, USA., Kaye D; Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia., Hasenfuß G; Georg-August Universität, Heart Centre, Gottingen, Germany., Hayward C; Department of Cardiology, St-Jan Hospital, Bruges, Belgium., Van der Heyden J; Department of Cardiology, St-Jan Hospital, Bruges, Belgium., Petrie MC; Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK., Shah SJ; Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA., Borlaug BA; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA., Kahwash R; The Ohio State University Wexner Medical Center, Columbus, OH, USA., Litwin S; Medical University of South Carolina, Charleston, SC, USA., Hoendermis E; University Medical Center, Groningen, The Netherlands., Hummel S; University of Michigan Frankel Cardiovascular Center, Ann Arbor, MI, USA.; Ann Arbor Veterans Affairs Health System, Ann Arbor, MI, USA., Gustafsson F; Department of Cardiology, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, Copenhagen, 2100, Denmark.
Jazyk: angličtina
Zdroj: ESC heart failure [ESC Heart Fail] 2022 Feb; Vol. 9 (1), pp. 186-195. Date of Electronic Publication: 2021 Dec 08.
DOI: 10.1002/ehf2.13697
Abstrakt: Aims: This study aimed to describe haemodynamic features of patients with advanced heart failure with preserved ejection fraction (HFpEF) as defined by the Heart Failure Association (HFA) of the European Society of Cardiology (ESC).
Methods and Results: We used pooled data from two dedicated HFpEF studies with invasive exercise haemodynamic protocols, the REDUCE LAP-HF (Reduce Elevated Left Atrial Pressure in Patients with Heart Failure) trial and the REDUCE LAP-HF I trial, and categorized patients according to advanced heart failure (AdHF) criteria. The well-characterized HFpEF patients were considered advanced if they had persistent New York Heart Association classification of III-IV and heart failure (HF) hospitalization < 12 months and a 6 min walk test distance < 300 m. Twenty-four (22%) out of 108 patients met the AdHF criteria. On evaluation, clinical characteristics and resting haemodynamics were not different in the two groups. Patients with AdHF had lower work capacity compared with non-advanced patients (35 ± 16 vs. 45 ± 18 W, P = 0.021). Workload-corrected pulmonary capillary wedge pressure normalized to body weight (PCWL) was higher in AdHF patients compared with non-advanced (112 ± 55 vs. 86 ± 49 mmHg/W/kg, P = 0.04). Further, AdHF patients had a smaller increase in cardiac index during exercise (1.1 ± 0.7 vs. 1.6 ± 0.9 L/min/m 2 , P = 0.028).
Conclusions: A significantly higher PCWL and lower cardiac index reserve during exercise were observed in AdHF patients compared with non-advanced. These differences were not apparent at rest. Therapies targeting the haemodynamic compromise associated with advanced HFpEF are needed.
(© 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)
Databáze: MEDLINE
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