Resting and exercise haemodynamic characteristics of patients with advanced heart failure and preserved ejection fraction
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Resting and exercise haemodynamic characteristics of patients with advanced heart failure and preserved ejection fraction. / Deis, T.; Wolsk, E.; Mujkanovic, J.; Komtebedde, J.; Burkhoff, D.; Kaye, D.; Hasenfuß, G.; Hayward, C.; Van der Heyden, J.; Petrie, M. C.; Shah, S. J.; Borlaug, B. A.; Kahwash, R.; Litwin, S.; Hoendermis, E.; Hummel, S.; Gustafsson, F.
I: E S C Heart Failure, Bind 9, Nr. 1, 2022, s. 186-195.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Resting and exercise haemodynamic characteristics of patients with advanced heart failure and preserved ejection fraction
AU - Deis, T.
AU - Wolsk, E.
AU - Mujkanovic, J.
AU - Komtebedde, J.
AU - Burkhoff, D.
AU - Kaye, D.
AU - Hasenfuß, G.
AU - Hayward, C.
AU - Van der Heyden, J.
AU - Petrie, M. C.
AU - Shah, S. J.
AU - Borlaug, B. A.
AU - Kahwash, R.
AU - Litwin, S.
AU - Hoendermis, E.
AU - Hummel, S.
AU - Gustafsson, F.
N1 - Publisher Copyright: © 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
PY - 2022
Y1 - 2022
N2 - 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/m2, 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.
AB - 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/m2, 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.
U2 - 10.1002/ehf2.13697
DO - 10.1002/ehf2.13697
M3 - Journal article
C2 - 34877822
AN - SCOPUS:85120670431
VL - 9
SP - 186
EP - 195
JO - E S C Heart Failure
JF - E S C Heart Failure
SN - 2055-5822
IS - 1
ER -
ID: 346051254