Key result
Patients with HFmrEF achieved lower peak METs than healthy controls during progressive exercise (5.6 vs 7.4; p=0.002) but maintained stroke volume at peak exercise.
Why the study?
The study was conducted to assess acute changes in left atrial function during progressive exercise in patients with heart failure with mid-range ejection fraction compared to healthy controls.
Does progressive exercise alter left atrial function differently in patients with HFmrEF compared to healthy controls?
Case-Control (n=30)
Does progressive exercise alter left atrial function differently in patients with HFmrEF compared to healthy controls?
Absolute Event Rate: 5.6% vs 7.4%
p-value: p=0.002
Patients with HFmrEF demonstrate an appropriate increase in left atrial reservoir function during incremental exercise, which helps maintain stroke volume.
Background: the aim of this study was to assess acute changes on left atrial (LA) function a during a progressive exercise in patients with heart failure with mid-range ejection fraction (HFmrEF) in comparison to healthy controls (HS). Methods: twenty patients with established HFmrEF were compared with 10 HS, age-matched controls. All subiects performed a stepwise exercise test on cyclette. Echocardiography was performed at baseline, during submaximal effort, at peak of exercise, and after 5 minutes of recovery. Results: HS obtained an higher value of METs at peak exercise than HFmrEF (7.4 vs 5.6; between group p 0.002). Heart rate and systolic blood pressure presented a greater increase in the HS group than in HFmrEF (between-groups p 0.006 and p 0.003 respectively). In the HFmrEF group peak atrial longitudinal strain (PALS), and conduit strain were both increased at submaximal exercise (p<0.05 for both versus baseline) and remained constant at peak exercise. Peak atrial contraction strain (PACS) did not show significant changes during the exercise. In the control group PALS and PACS increased significantly at submaximal level (p<0.05 for both versus baseline) but PALS returned near baseline values at peak exercise; conduit strain decreased progressively during the exercise in HS. Stroke volume (SV) increased in both groups at submaximal exercise; at peak exercise SV remained constant in the HFmrEF while it decreased in controls (between-groups p 0.002). Conclusions: Patient with HFmrEF, show a proper increase of LA reservoir function during incremental exercise that contributes to maintain SV throughout the exercise.
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Iellamo et al. (2023) conducted a case-control in Heart failure with mildly-reduced ejection fraction (HFmrEF) (n=30). Heart failure with mildly-reduced ejection fraction (HFmrEF) vs. Healthy controls was evaluated on METs at peak exercise (p=0.002). Patients with HFmrEF achieved lower peak METs than healthy controls during progressive exercise (5.6 vs 7.4; p=0.002) but maintained stroke volume at peak exercise.
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