Clinical Significance of Exercise Pulmonary Hypertension With a Negative Diastolic Stress Test for Suspected Heart Failure With Preserved Ejection Fraction.
| Autor: | Verwerft J; Department of Cardiology Jessa Hospital Hasselt Belgium.; Faculty of Medicine and Life Sciences Biomedical Research Institute, Hasselt University Hasselt Belgium., Stassen J; Department of Cardiology Jessa Hospital Hasselt Belgium.; Faculty of Medicine and Life Sciences Biomedical Research Institute, Hasselt University Hasselt Belgium., Falter M; Department of Cardiology Jessa Hospital Hasselt Belgium.; Faculty of Medicine and Life Sciences Biomedical Research Institute, Hasselt University Hasselt Belgium., Bekhuis Y; Department of Cardiology Jessa Hospital Hasselt Belgium.; Faculty of Medicine and Life Sciences Biomedical Research Institute, Hasselt University Hasselt Belgium.; Centre for Cardiovascular Diseases University Hospital Brussels Jette Belgium.; Faculty of Medicine and Pharmacy Vrije Universiteit Brussel Brussels Belgium.; Department of Cardiology Ziekenhuis-Oost Limburg Genk Belgium.; Department of Cardiovascular Sciences KU Leuven Leuven Belgium., Hoedemakers S; Department of Cardiology Jessa Hospital Hasselt Belgium.; Faculty of Medicine and Life Sciences Biomedical Research Institute, Hasselt University Hasselt Belgium.; Centre for Cardiovascular Diseases University Hospital Brussels Jette Belgium.; Faculty of Medicine and Pharmacy Vrije Universiteit Brussel Brussels Belgium., Gojevic T; Faculty of Medicine and Pharmacy Vrije Universiteit Brussel Brussels Belgium., Ferreira SM; Department of Cardiology Jessa Hospital Hasselt Belgium.; Faculty of Medicine and Life Sciences Biomedical Research Institute, Hasselt University Hasselt Belgium., Vanhentenrijk S; Department of Cardiology Jessa Hospital Hasselt Belgium.; Centre for Cardiovascular Diseases University Hospital Brussels Jette Belgium.; Faculty of Medicine and Pharmacy Vrije Universiteit Brussel Brussels Belgium., Stroobants S; Department of Cardiology Jessa Hospital Hasselt Belgium.; Faculty of Medicine and Life Sciences Biomedical Research Institute, Hasselt University Hasselt Belgium., Jogani S; Department of Cardiology Jessa Hospital Hasselt Belgium.; Faculty of Medicine and Life Sciences Biomedical Research Institute, Hasselt University Hasselt Belgium., Hansen D; Faculty of Rehabilitation Sciences REVAL/BIOMED, Hasselt University Hasselt Belgium., Jasaityte R; Department of Cardiology Jessa Hospital Hasselt Belgium.; Faculty of Medicine and Life Sciences Biomedical Research Institute, Hasselt University Hasselt Belgium., Cosyns B; Centre for Cardiovascular Diseases University Hospital Brussels Jette Belgium.; Faculty of Medicine and Pharmacy Vrije Universiteit Brussel Brussels Belgium., Van De Bruaene A; Department of Cardiology Jessa Hospital Hasselt Belgium.; Department of Cardiovascular Sciences KU Leuven Leuven Belgium., Bertrand PB; Faculty of Medicine and Life Sciences Biomedical Research Institute, Hasselt University Hasselt Belgium.; Department of Cardiology Ziekenhuis-Oost Limburg Genk Belgium., de Boer RA; Department of Cardiology Erasmus MC Rotterdam The Netherlands., Gevaert AB; Research Group Cardiovascular Diseases, GENCOR Department University of Antwerp Belgium.; Department of Cardiology Antwerp University Hospital (UZA) Edegem Belgium., Verbrugge FH; Centre for Cardiovascular Diseases University Hospital Brussels Jette Belgium.; Faculty of Medicine and Pharmacy Vrije Universiteit Brussel Brussels Belgium., Herbots L; Department of Cardiology Jessa Hospital Hasselt Belgium.; Faculty of Medicine and Life Sciences Biomedical Research Institute, Hasselt University Hasselt Belgium., Claessen G; Department of Cardiology Jessa Hospital Hasselt Belgium.; Faculty of Medicine and Life Sciences Biomedical Research Institute, Hasselt University Hasselt Belgium.; Department of Cardiovascular Sciences KU Leuven Leuven Belgium.; Faculty of Rehabilitation Sciences REVAL/BIOMED, Hasselt University Hasselt Belgium.; Baker Heart and Diabetes Institute Melbourne Australia. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Journal of the American Heart Association [J Am Heart Assoc] 2024 Aug 06; Vol. 13 (15), pp. e032228. Date of Electronic Publication: 2024 Jul 19. |
| DOI: | 10.1161/JAHA.123.032228 |
| Abstrakt: | Background: Half of patients with heart failure with preserved ejection fraction (HFpEF) remain undiagnosed by resting evaluation alone. Therefore, exercise testing is proposed. The diastolic stress test (DST), however, has limited sensitivity. We aimed to determine the clinical significance of adding the mean pulmonary artery pressure over cardiac output (mPAP/CO) slope to the DST in suspected HFpEF. Methods and Results: In this prospective cohort study, consecutive patients (n=1936) with suspected HFpEF underwent exercise echocardiography with simultaneous respiratory gas analysis. These patients were stratified by exercise E over e ' (exE/ e ') and mPAP/CO slope, and peak oxygen uptake, natriuretic peptides (NT-proBNP [N-terminal pro-B-type natriuretic peptide]), and score-based HFpEF likelihood were compared. Twenty-two percent of patients (n=428) had exE/ e '<15 despite a mPAP/CO slope>3 mm Hg/L per min, 24% (n=464) had a positive DST (exE/ e '≥15), and 54% (n=1044) had a normal DST and slope. Percentage of predicted oxygen uptake was similar in the group with exE/ e '<15 but high mPAP/CO slope and the positive DST group (-2% [-5% to +1%]), yet worse than in those with normal DST and slope (-12% [-14% to -9%]). Patients with exE/ e '<15 but a high slope had NT-proBNP levels and H Conclusions: Twenty-two percent of patients with suspected HFpEF presented with a mPAP/CO slope>3 mm Hg/L per min despite a negative DST. These patients had HFpEF characteristics and a peak oxygen uptake as low as patients with a positive DST. Therefore, an elevated mPAP/CO slope might indicate HFpEF irrespective of the DST result. |
| Databáze: | MEDLINE |
| Externí odkaz: |
|
Plný text