Stress Imaging in Heart Failure
Key result
Assessment of systolic, diastolic, and ventricular interaction responses to leg-positive pressure independently predicted adverse cardiovascular events in patients with HFrEF.
Population
120 patients with heart failure with reduced ejection fraction (HFrEF)
Comparison
Echocardiography during an acute increase in… vs Echocardiography at rest
Design
Editorial
Authors
Discussion
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Implication
Stress echocardiography using leg-positive pressure to augment preload reveals impaired Frank-Starling reserve and enhanced diastolic ventricular interaction, offering incremental prognostic value in HFrEF.
Structured PICO
P
Population
120 patients with heart failure with reduced ejection fraction undergoing echocardiography at rest and during leg-positive pressure to evaluate cardiovascular event risk.
E
Exposure
Echocardiography during an acute increase in cardiac venous return induced by leg-positive pressure (LPP)
C
Comparator
Echocardiography at rest
O
Outcome
Cardiovascular eventssurrogate
Stress echocardiography using leg-positive pressure to augment preload reveals impaired Frank-Starling reserve and enhanced diastolic ventricular interaction, offering incremental prognostic value in HFrEF.
Limitations
- Data are not adequate to prove causality
- Inferior vena cava diameter is a crude estimate of central venous filling pressures
- Did not evaluate pulmonary artery pressures or worsening tricuspid regurgitation during stress
- Changes in inferior vena cava diameter is a crude estimate of central venous filling pressures
Cite This Study
Obokata et al. (2018) conducted an editorial in Heart failure with reduced ejection fraction (HFrEF) (n=120). Leg-positive pressure (LPP) vs. Resting evaluation was evaluated on Cardiovascular events. Assessment of systolic, diastolic, and ventricular interaction responses to leg-positive pressure independently predicted adverse cardiovascular events in patients with HFrEF.