Key result
Patients with HFpEF exhibited significantly decreased peak VO2 (12.0 vs 19.1 mL/min/kg, P<0.001) and elevated inflammatory and oxidative stress biomarkers compared with healthy controls.
Observational (n=32)
Patients with HFpEF demonstrate significantly reduced cardiopulmonary reserve and elevated inflammatory and oxidative stress biomarkers compared to healthy controls, despite similar peripheral arterial blood flow.
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Inflammation may contribute to HFpEF exercise intolerance; hypothesis-generating and should not yet change practice.
Background. Changes in cardiopulmonary reserve and biomarkers related to wall stress, inflammation, and oxidative stress concomitantly with the evaluation of peripheral arterial blood flow have not been investigated in patients with heart failure with preserved ejection fraction (HFpEF) compared with healthy subjects (CTL). Methods and Results. Eighteen HFpEF patients and 14 CTL were recruited. Plasma levels of inflammatory and oxidative stress biomarkers were measured at rest. Brain natriuretic peptide (BNP) was measured at rest and peak exercise. Cardiopulmonary reserve was assessed using an exercise protocol with gas exchange analyses. Peripheral arterial blood flow was determined by strain gauge plethysmography. Peak VO2 (12.0 ± 0.4 versus 19.1 ± 1.1 mL/min/kg, P < 0.001) and oxygen uptake efficiency slope (1.55 ± 0.12 versus 2.06 ± 0.14, P < 0.05) were significantly decreased in HFpEF patients compared with CTL. BNP at rest and following stress, C-reactive-protein, interleukin-6, and TBARS were significantly elevated in HFpEF. Both basal and posthyperemic arterial blood flow were not significantly different between the HFpEF patients and CTL. Conclusions. HFpEF exhibits a severe reduction in cardiopulmonary reserve and oxygen uptake efficiency concomitantly with an elevation in a broad spectrum of biomarkers confirming an inflammatory and prooxidative status in patients with HFpEF.
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Vitiello et al. (2014) conducted an observational in Heart failure with preserved ejection fraction (n=32). Heart failure with preserved ejection fraction vs. Healthy subjects was evaluated on Peak VO2 (mL/min/kg) (p=<0.001). Patients with HFpEF exhibited significantly decreased peak VO2 (12.0 vs 19.1 mL/min/kg, P<0.001) and elevated inflammatory and oxidative stress biomarkers compared with healthy controls.
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