Key result
Exercise stress echocardiography facilitates HFpEF diagnosis and risk stratification by identifying elevated LV filling pressures.
Why the study?
Diagnosis of HFpEF remains challenging in patients with a lower degree of congestion whose left ventricular filling pressures are normal at rest but abnormal during exercise.
Exercise stress echocardiography is a valuable noninvasive tool for the early diagnosis and comprehensive evaluation of HFpEF, particularly when resting echocardiographic parameters are inconclusive.
May support HFpEF evaluation when resting findings are inconclusive; hypothesis-generating and requires prospective validation before practice change.
Heart failure with preserved ejection fraction (HFpEF) accounts for nearly 70% of all HF and has become the dominant form of HF. The increased prevalence of HFpEF has contributed to a rise in the number of HF patients, known as the "heart failure pandemic". In addition to the fact that HF is a progressive disease and a delayed diagnosis may worsen clinical outcomes, the emergence of disease-modifying treatments such as sodium-glucose transporter 2 inhibitors and glucagon-like peptide-1 receptor agonists has made appropriate and timely identification of HFpEF even more important. However, diagnosis of HFpEF remains challenging in patients with a lower degree of congestion. In addition to normal EF, this is related to the fact that left ventricular (LV) filling pressures are often normal at rest but become abnormal during exercise. Exercise stress echocardiography can identify such exercise-induced elevations in LV filling pressures and facilitate the diagnosis of HFpEF. Exercise stress echocardiography may also be useful for risk stratification and assessment of exercise tolerance as well as cardiovascular responses to exercise. Recent attention has focused on dedicated dyspnea clinics to identify early HFpEF among patients with unexplained dyspnea and to investigate the causes of dyspnea. This review discusses the role of exercise stress echocardiography in the diagnosis and evaluation of HFpEF.
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Yuasa et al. (2024) conducted a review in Heart failure with preserved ejection fraction (HFpEF). Exercise stress echocardiography was evaluated. Exercise stress echocardiography identifies exercise-induced elevations in left ventricular filling pressures, facilitating the diagnosis and risk stratification of heart failure with preserved ejection fraction.
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