Impaired oxygen uptake kinetics in heart failure with preserved ejection fraction
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Key result
HFpEF patients exhibit ~25 seconds slower VO2 kinetics during submaximal exercise versus healthy controls.
- MD 25.3 s
- 95% CI 10.4-40.2
- P<0.002
- n=36
Why the study?
Oxygen uptake kinetics are impaired in heart failure with reduced ejection fraction, but whether they are slowed in heart failure with preserved ejection fraction was unknown.
Are V̇O2 kinetics slowed during submaximal exercise in patients with HFpEF compared to healthy controls?
Population
18 HFpEF patients and 18 healthy controls
Comparison
HFpEF patients vs healthy controls
Design
Case-control study
Authors
Discussion
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Implication
May indicate peripheral extraction impairment in HFpEF; hypothesis-generating and requires prospective validation before clinical use.
Study Design
Type
Cross-Sectional (n=36)
Multicenter
No
Structured PICO
Are V̇O2 kinetics slowed during submaximal exercise in patients with HFpEF compared to healthy controls?
P
Population
36 older adults (18 with HFpEF and 18 healthy controls) underwent submaximal and peak exercise testing to assess oxygen uptake kinetics.
E
Exposure
Submaximal and peak exercise testing with measurement of cardiac output, ventilatory oxygen uptake, and arterial-venous O2 difference.
C
Comparator
Healthy controls.
O
Outcome
V̇O2 kinetics quantified as mean response time (MRT) during submaximal exercise.surrogate
Main Result
Mean Difference: 25.3 (95% CI 10.4–40.2)
Absolute Event Rate: 65.4% vs 40.1%
p-value: p=<0.002
HFpEF patients exhibit slowed oxygen uptake kinetics during submaximal exercise, which is associated with impaired peripheral oxygen extraction.
Limitations
- Small sample size
- Cannot exclude a possible contribution of impaired cardiac output to slowed uptake kinetics due to reduced chronotropy
- Larger prospective studies are necessary to validate the phenotypic findings of the MRT >60 s subanalysis
Cite This Study
Hearon et al. (2019) conducted a cross-sectional in Heart failure with preserved ejection fraction (HFpEF) (n=36). Heart failure with preserved ejection fraction vs. Healthy controls was evaluated on Mean response time (MRT) of V̇O2 kinetics during submaximal exercise (MD 25.3 s, 95% CI 10.4-40.2, p=<0.002). Patients with heart failure with preserved ejection fraction had markedly slowed oxygen uptake kinetics during submaximal exercise compared to healthy controls (mean response time 65.4 vs 40.1 s, p<0.002).
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