Key result
Loss of cardiac output augmentation during exercise was associated with ventilatory inefficiency in both HFpEF and HFrEF, whereas lung congestion (E/e') determined ventilatory efficiency only in HFpEF.
Why the study?
Ventilatory inefficiency during exercise is a strong prognostic marker in heart failure regardless of LVEF, but its physiological background has not been elucidated.
Observational (n=57)
No
Effect estimate: r=-0.44 for CO in HFpEF; r=-0.54 for CO in HFrEF
p-value: p=<0.05
Loss of cardiac output augmentation is associated with ventilatory inefficiency during exercise in both HFpEF and HFrEF, whereas lung congestion (reflected by E/e') determines ventilatory efficiency only in HFpEF.
May inform differential assessment of exercise intolerance in HFpEF vs HFrEF; leaves open phenotype-specific interventions.
Background:Ventilatory inefficiency during exercise assessed using the lowest minute ventilation/carbon dioxide production (V̇E/V̇CO2) ratio was recently proven to be a strong prognostic marker of heart failure (HF) regardless of left ventricular ejection fraction (LVEF). Its physiological background, however, has not been elucidated.
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Tsujinaga et al. (2020) conducted an observational in Heart Failure (HFpEF and HFrEF) (n=57). Heart failure with preserved vs reduced ejection fraction vs. HFrEF vs HFpEF was evaluated on Correlation between lowest VE/VCO2 ratio and echocardiographic parameters during exercise (r=-0.44 for CO in HFpEF; r=-0.54 for CO in HFrEF, p=<0.05). Loss of cardiac output augmentation during exercise was associated with ventilatory inefficiency in both HFpEF and HFrEF, whereas lung congestion (E/e') determined ventilatory efficiency only in HFpEF.
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