PMID- 29788047
OWN - NLM
STAT- MEDLINE
DCOM- 20191127
LR  - 20240207
IS  - 1522-9645 (Electronic)
IS  - 0195-668X (Print)
IS  - 0195-668X (Linking)
VI  - 39
IP  - 30
DP  - 2018 Aug 7
TI  - Haemodynamics, dyspnoea, and pulmonary reserve in heart failure with preserved 
      ejection fraction.
PG  - 2810-2821
LID - 10.1093/eurheartj/ehy268 [doi]
AB  - AIMS: Increases in left ventricular filling pressure are a fundamental 
      haemodynamic abnormality in heart failure with preserved ejection fraction 
      (HFpEF). However, very little is known regarding how elevated filling pressures 
      cause pulmonary abnormalities or symptoms of dyspnoea. We sought to determine the 
      relationships between simultaneously measured central haemodynamics, symptoms, 
      and lung ventilatory and gas exchange abnormalities during exercise in HFpEF. 
      METHODS AND RESULTS: Subjects with invasively-proven HFpEF (n = 50) and 
      non-cardiac causes of dyspnoea (controls, n = 24) underwent cardiac 
      catheterization at rest and during exercise with simultaneous expired gas 
      analysis. During submaximal (20 W) exercise, subjects with HFpEF displayed higher 
      pulmonary capillary wedge pressures (PCWP) and pulmonary artery pressures, higher 
      Borg perceived dyspnoea scores, and increased ventilatory drive and respiratory 
      rate. At peak exercise, ventilation reserve was reduced in HFpEF compared with 
      controls, with greater dead space ventilation (higher VD/VT). Increasing exercise 
      PCWP was directly correlated with higher perceived dyspnoea scores, lower peak 
      exercise capacity, greater ventilatory drive, worse New York Heart Association 
      (NYHA) functional class, and impaired pulmonary ventilation reserve. CONCLUSION: 
      This study provides the first evidence linking altered exercise haemodynamics to 
      pulmonary abnormalities and symptoms of dyspnoea in patients with HFpEF. Further 
      study is required to identify the mechanisms by which haemodynamic derangements 
      affect lung function and symptoms and to test novel therapies targeting exercise 
      haemodynamics in HFpEF.
FAU - Obokata, Masaru
AU  - Obokata M
AD  - The Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, USA.
FAU - Olson, Thomas P
AU  - Olson TP
AD  - The Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, USA.
FAU - Reddy, Yogesh N V
AU  - Reddy YNV
AD  - The Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, USA.
FAU - Melenovsky, Vojtech
AU  - Melenovsky V
AD  - The Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, USA.
FAU - Kane, Garvan C
AU  - Kane GC
AD  - The Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, USA.
FAU - Borlaug, Barry A
AU  - Borlaug BA
AD  - The Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, USA.
LA  - eng
GR  - R01 HL126638/HL/NHLBI NIH HHS/United States
GR  - T32 HL007111/HL/NHLBI NIH HHS/United States
GR  - U10 HL110262/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
SB  - IM
CIN - Eur Heart J. 2018 Aug 7;39(30):2822-2824. PMID: 29939237
MH  - Aged
MH  - Dyspnea/*etiology
MH  - Exercise Test
MH  - Female
MH  - Heart Failure/*complications/*physiopathology
MH  - *Hemodynamics
MH  - Humans
MH  - Lung/*physiopathology
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - *Stroke Volume
PMC - PMC6658816
EDAT- 2018/05/23 06:00
MHDA- 2019/11/28 06:00
PMCR- 2019/08/07
CRDT- 2018/05/23 06:00
PHST- 2017/12/14 00:00 [received]
PHST- 2018/04/30 00:00 [accepted]
PHST- 2018/05/23 06:00 [pubmed]
PHST- 2019/11/28 06:00 [medline]
PHST- 2018/05/23 06:00 [entrez]
PHST- 2019/08/07 00:00 [pmc-release]
AID - 4999864 [pii]
AID - ehy268 [pii]
AID - 10.1093/eurheartj/ehy268 [doi]
PST - ppublish
SO  - Eur Heart J. 2018 Aug 7;39(30):2810-2821. doi: 10.1093/eurheartj/ehy268.