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Statements

Subject Item
n2:RIV%2F00023001%3A_____%2F13%3A00058607%21RIV14-MZ0-00023001
rdf:type
n5:Vysledek skos:Concept
rdfs:seeAlso
http://eurjhf.oxfordjournals.org/content/15/7/776.full.pdf+html
dcterms:description
Exercise intolerance is a hallmark of heart failure with preserved ejection fraction (HFpEF), yet its mechanisms remain unclear. The current study sought to determine whether increases in cardiac output (CO) during exercise are appropriately matched to metabolic demands in HFpEF. Patients with HFpEF (n 109) and controls (n 73) exercised to volitional fatigue with simultaneous invasive (n 96) or non-invasive (n 86) haemodynamic assessment and expired gas analysis to determine oxygen consumption (VO2) during upright or supine exercise. At rest, HFpEF patients had higher LV filling pressures but similar heart rate, stroke volume, EF, and CO. During supine and upright exercise, HFpEF patients displayed lower peak VO2 coupled with blunted increases in heart rate, stroke volume, EF, and CO compared with controls. LV filling pressures increased dramatically in HFpEF patients, with secondary elevation in pulmonary artery pressures. Reduced peak VO2 in HFpEF patients was predominantly attributable to CO limitation, as the slope of the increase in CO relative to VO2 was 20 lower in HFpEF patients (5.9 2.5 vs. 7.4 2.6 L blood/L O-2, P 0.0005). While absolute increases in arterialvenous O-2 difference with exercise were similar in HFpEF patients and controls, augmentation in arterialvenous O-2 difference relative to VO2 was greater in HFpEF patients (8.9 3.4 vs. 5.5 2.0 min/dL, P 0.0001). These differences were observed in the total cohort and when upright and supine exercise modalities were examined individually. While diastolic dysfunction promotes congestion and pulmonary hypertension with stress in HFpEF, reduction in exercise capacity is predominantly related to inadequate CO relative to metabolic needs. Exercise intolerance is a hallmark of heart failure with preserved ejection fraction (HFpEF), yet its mechanisms remain unclear. The current study sought to determine whether increases in cardiac output (CO) during exercise are appropriately matched to metabolic demands in HFpEF. Patients with HFpEF (n 109) and controls (n 73) exercised to volitional fatigue with simultaneous invasive (n 96) or non-invasive (n 86) haemodynamic assessment and expired gas analysis to determine oxygen consumption (VO2) during upright or supine exercise. At rest, HFpEF patients had higher LV filling pressures but similar heart rate, stroke volume, EF, and CO. During supine and upright exercise, HFpEF patients displayed lower peak VO2 coupled with blunted increases in heart rate, stroke volume, EF, and CO compared with controls. LV filling pressures increased dramatically in HFpEF patients, with secondary elevation in pulmonary artery pressures. Reduced peak VO2 in HFpEF patients was predominantly attributable to CO limitation, as the slope of the increase in CO relative to VO2 was 20 lower in HFpEF patients (5.9 2.5 vs. 7.4 2.6 L blood/L O-2, P 0.0005). While absolute increases in arterialvenous O-2 difference with exercise were similar in HFpEF patients and controls, augmentation in arterialvenous O-2 difference relative to VO2 was greater in HFpEF patients (8.9 3.4 vs. 5.5 2.0 min/dL, P 0.0001). These differences were observed in the total cohort and when upright and supine exercise modalities were examined individually. While diastolic dysfunction promotes congestion and pulmonary hypertension with stress in HFpEF, reduction in exercise capacity is predominantly related to inadequate CO relative to metabolic needs.
dcterms:title
Cardiac output response to exercise in relation to metabolic demand in heart failure with preserved ejection fraction Cardiac output response to exercise in relation to metabolic demand in heart failure with preserved ejection fraction
skos:prefLabel
Cardiac output response to exercise in relation to metabolic demand in heart failure with preserved ejection fraction Cardiac output response to exercise in relation to metabolic demand in heart failure with preserved ejection fraction
skos:notation
RIV/00023001:_____/13:00058607!RIV14-MZ0-00023001
n5:predkladatel
n6:ico%3A00023001
n3:aktivita
n18:N
n3:aktivity
N
n3:cisloPeriodika
7
n3:dodaniDat
n11:2014
n3:domaciTvurceVysledku
n19:4066332
n3:druhVysledku
n17:J
n3:duvernostUdaju
n8:S
n3:entitaPredkladatele
n10:predkladatel
n3:idSjednocenehoVysledku
64278
n3:idVysledku
RIV/00023001:_____/13:00058607
n3:jazykVysledku
n15:eng
n3:klicovaSlova
Heart rate; Stroke volume; Cardiac output; Oxygen consumption; Exercise; Diastolic heart failure
n3:klicoveSlovo
n7:Stroke%20volume n7:Heart%20rate n7:Oxygen%20consumption n7:Diastolic%20heart%20failure n7:Exercise n7:Cardiac%20output
n3:kodStatuVydavatele
GB - Spojené království Velké Británie a Severního Irska
n3:kontrolniKodProRIV
[7989955E625D]
n3:nazevZdroje
European journal of heart failure
n3:obor
n12:FA
n3:pocetDomacichTvurcuVysledku
1
n3:pocetTvurcuVysledku
7
n3:rokUplatneniVysledku
n11:2013
n3:svazekPeriodika
15
n3:tvurceVysledku
Kass, D. A. Johnson, BD Melenovský, Vojtěch Abudiab, MM Olson, TP Redfield, MM Borlaug, BA
n3:wos
000320857400013
s:issn
1388-9842
s:numberOfPages
10
n16:doi
10.1093/eurjhf/hft026