Article

We are unaware of any previous investigation that has compared the
relationship of key cardiopulmonary exercise testing (CPX) variables to various
measures of pathophysiology between heart failure-reduced ejection fraction
(HFrEF) and HF-preserved ejection fraction (HFpEF) cohorts that are well matched
with respect to baseline characteristics and their exercise response, which is
the purpose of the present study. METHODS: Thirty-four patients with HFpEF were
randomly matched to 34 subjects with HFrEF according to age and sex as well as
peak oxygen consumption (VO2), ventilatory efficiency (VE/VCO2 slope), and
exercise oscillatory ventilation (EOV). In addition to CPX, patients also
underwent echocardiography with tissue Doppler imaging (TDI) and assessment of
N-terminal pro-B-type natriuretic peptide (NT-proBNP). RESULTS: When matched for
age, sex, and CPX variables, the HFrEF and HFpEF cohorts had similar
echocardiography with TDI and NT-proBNP values, indicating comparable disease
severity. In addition, the correlations between key CPX measures (peak VO2 and
VE/VCO2 slope) and echocardiography with TDI and NT-proBNP measures were similar
between HFrEF and HFpEF groups. Of note, the correlation between the VE/VCO2
slope and pulmonary artery systolic pressure and NT-proBNP was highly significant
in both groups (r >/= 0.65, p < 0.01). Moreover, subjects with EOV in both groups
had a significantly higher PASP ( approximately 47 vs. approximately 35 mmHg, p <
0.05). CONCLUSIONS: The results of the current study indicate CPX equally
represents disease severity in HFrEF and HFpEF patients.
This is a novel finding
supporting the key role of CPX in the clinical follow-up of HF patients irrespective of LVEF and cardiac phenotype.
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Langue : ANGLAIS