Is peak C(a-v)o2 a major determinant of exercise capacity in patients with HFpEF compared to HFrEF and normal controls?
Patients with heart failure with preserved ejection fraction (HFpEF), heart failure with reduced ejection fraction (HFrEF), and normal controls
Direct measurement of arteriovenous oxygen content difference (C(a-v)o2) throughout exercise
Comparison between HFpEF, HFrEF, and normal control groups
Peak C(a-v)o2 and its relationship to exercise capacitysurrogate
Impaired peripheral oxygen extraction is a major determinant of exercise intolerance in HFpEF, suggesting skeletal muscle or peripheral microvascular function as potential therapeutic targets.
In the first study to directly measure C(a-v)o2 throughout exercise in HFpEF, HFrEF, and normals, we found that peak C(a-v)o2 was a major determinant of exercise capacity in HFpEF. The important functional limitation imposed by impaired o2 extraction may reflect intrinsic abnormalities in skeletal muscle or peripheral microvascular function, and represents a potential target for therapeutic intervention.
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Bishnu P. Dhakal
Electrophysiology
Rajeev Malhotra
Heart Failure & Transplant
Ryan M. Murphy
University of North Carolina at Chapel Hill
Circulation Heart Failure
Massachusetts General Hospital
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Dhakal et al. (Sat,) studied this question.
synapsesocial.com/papers/69d56e0f75589c71d767d337 — DOI: https://doi.org/10.1161/circheartfailure.114.001825