Key result
Current diagnostic methods for exercise-induced heart failure with normal ejection fraction yield conflicting results and face significant limitations, necessitating new diagnostic approaches.
Why the study?
How can isolated, exercise-induced heart failure with normal ejection fraction be reliably diagnosed?
How can isolated, exercise-induced heart failure with normal ejection fraction be reliably diagnosed?
Current diagnostic approaches for exercise-induced HFNEF, including exercise echocardiography and invasive LVFP measurement, lack consensus and require further research to establish reliable diagnostic criteria.
Diagnostic challenges limit reliable identification of exercise-induced HFNEF; leaves open the need for standardized criteria and prospective validation.
BACKGROUND: A significant proportion of patients with exertional dyspnea require exercise to diagnose heart failure with normal ejection fraction (HFNEF). METHODS AND RESULTS: In this review article, we evaluate current data on the prevalence, clinical significance and specifically the establishment of a diagnosis of isolated, exercise-induced HFNEF. Despite the unquestioned clinical importance and high prevalence of exercise-induced HFNEF, there are limited and conflicting data on making a diagnosis of exercise-induced HFNEF. This mostly relies on the evidence of exercise-induced elevation in left ventricular filling pressure (LVFP). At present, there is no agreement on the ability of exercise echocardiographic parameteres to predict exercise-induced LVFP elevation. In addition, even invasively measured exercise LVFP faces the problem of defining normal exercise LVFP values. More data and probably new diagnostic approaches are necessary to reliably diagnose exercise HFNEF. CONCLUSIONS: There are conflicting results and significant problems associated with the diagnosis of exercise HFNEF. This review hopefully will encourage further research in this difficult but clinically important area of heart failure.
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Meluzı́n et al. (2015) conducted a review in Exercise-induced heart failure with normal ejection fraction (HFNEF). Exercise echocardiography and invasive left ventricular filling pressure measurement was evaluated. Current diagnostic methods for exercise-induced heart failure with normal ejection fraction yield conflicting results and face significant limitations, necessitating new diagnostic approaches.
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