In HFpEF, reduced exercise capacity is primarily driven by inadequate cardiac output relative to metabolic demand rather than just diastolic dysfunction.
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May shift focus toward cardiac output augmentation in HFpEF; leaves open therapeutic impact pending prospective trials.
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.
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Abudiab et al. (2013) studied this question.
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