Determinants of pulmonary artery hypertension at rest and during exercise in patients with heart failure
Key result
A larger exercise increase in pulmonary artery systolic pressure (>60 mmHg) was associated with more frequent exercise interruption for dyspnea compared to smaller increases (70% vs. 27%; P=0.04).
Why the study?
What are the determinants of pulmonary artery hypertension at rest and during exercise in patients with heart failure?
Population
46 patients with left ventricular dysfunction (ejection fraction: 30 +/- 6%)
Design
Cross-sectional
Authors
Discussion
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Implication
Exercise PASP rise may mark exertional limitation in HF; leaves open whether targeting dynamic MR improves symptoms.
Study Design
Type
Observational (n=46)
Structured PICO
What are the determinants of pulmonary artery hypertension at rest and during exercise in patients with heart failure?
P
Population
46 patients with heart failure and left ventricular dysfunction (mean ejection fraction 30%) evaluated at rest and during exercise.
E
Exposure
Semi-recumbent, incremental bicycle exercise Doppler echocardiography
O
Outcome
Determinants of pulmonary artery systolic pressure (PASP) at rest and during exercisesurrogate
Main Result
Absolute Event Rate: 70% vs 27%
p-value: p=0.04
In patients with heart failure, dynamic mitral regurgitation is the primary determinant of exercise-induced pulmonary hypertension, whereas resting pulmonary pressure is driven by left atrial volume and resting mitral deformation.
Cite This Study
Tumminello et al. (2006) conducted an observational in Heart failure with left ventricular dysfunction (n=46). Larger exercise increase in pulmonary artery systolic pressure (>60 mmHg) vs. Smaller exercise increase in pulmonary artery systolic pressure was evaluated on Interruption of exercise for dyspnea (p=0.04). A larger exercise increase in pulmonary artery systolic pressure (>60 mmHg) was associated with more frequent exercise interruption for dyspnea compared to smaller increases (70% vs. 27%; P=0.04).