Studies Assess Heart Failure With Normal Ejection Fraction
Heart failure with preserved ejection fraction linked to global impairment in CV reserve function
WEDNESDAY, Sept. 1 (HealthDay News) -- Patients with heart failure with normal ejection fraction (HFNEF) have a similar peak exercise pulmonary capillary wedge pressure (PCWP) compared to controls but at a lower workload, and the condition is marked by depressed reserve capacity with a variety of issues related to cardiovascular function, according to two studies published in the Sept. 7 issue of the Journal of the American College of Cardiology.
In the first study, Micha T. Maeder, M.D., of the Baker IDI Heart and Diabetes Institute in Melbourne, Australia, and colleagues analyzed data from 14 patients with HFNEF and eight controls. The groups had similar resting and peak exercise PCWP, but the peak PCWP/work rate ratio was higher in the patients. Peak early diastolic transmitral velocity to peak early diastolic annular velocity ratio at peak exercise was similar between the groups, but at rest was somewhat elevated in the patients. The patients also stopped exercise at a lower work rate.
In the other study, Barry A. Borlaug, M.D., of the Mayo Clinic in Rochester, Minn., and colleagues analyzed data from 21 patients with heart failure and preserved ejection fraction (HFpEF), as well as patients with hypertension but no heart failure and subjects without cardiovascular disease. The heart failure patients had reduced exercise-induced increases in vasodilation, contractility, and chronotropy.
"HFpEF is characterized by depressed reserve capacity involving multiple domains of cardiovascular function, which contribute in an integrated fashion to produce exercise limitation. Appreciation of the global nature of reserve dysfunction in HFpEF will better inform optimal design for future diagnostic and therapeutic strategies," Borlaug and colleagues write.
A co-author of the second study disclosed a financial relationship with Itamar Medical.