Increased left ventricular stiffness in HFNEF patients significantly correlated with reduced peak oxygen uptake (r = -0.636, P < .001) and impaired overall exercise capacity.
Observational (n=39)
Does increased left ventricular stiffness correlate with impaired exercise capacity in patients with heart failure and normal ejection fraction?
Increased left ventricular stiffness, as measured by invasive pressure-volume loop analysis, is significantly correlated with impaired exercise capacity in patients with heart failure and normal ejection fraction.
Effect estimate: r = -0.636
p-value: p=<.001
Aims. Several mechanisms can be involved in the development of exercise intolerance in patients with heart failure despite normal left ventricular ejection fraction (HFNEF) and may include impairment of left ventricular (LV) stiffness. We therefore investigated the influence of LV stiffness, determined by pressure-volume loop analysis obtained by conductance catheterization, on exercise capacity in HFNEF. Methods and Results. 27 HFNEF patients who showed LV diastolic dysfunction in pressure-volume (PV) loop analysis performed symptom-limited cardiopulmonary exercise testing (CPET) and were compared with 12 patients who did not show diastolic dysfunction in PV loop analysis. HFNEF patients revealed a lower peak performance (P = .046), breathing reserve (P = .006), and ventilation equivalent for carbon dioxide production at rest (P = .002). LV stiffness correlated with peak oxygen uptake (r = -0.636, P < .001), peak oxygen uptake at ventilatory threshold (r = -0.500, P = .009), and ventilation equivalent for carbon dioxide production at ventilatory threshold (r = 0.529, P = .005). Conclusions. CPET parameters such as peak oxygen uptake, peak oxygen uptake at ventilatory threshold, and ventilation equivalent for carbon dioxide production at ventilatory threshold correlate with LV stiffness. Increased LV stiffness impairs exercise capacity in HFNEF.
Sinning et al. (2011) conducted an observational in Heart failure with normal left ventricular ejection fraction (HFNEF) (n=39). Left ventricular stiffness (exposure) vs. Patients without diastolic dysfunction in PV loop analysis was evaluated on Exercise capacity (peak oxygen uptake) (r = -0.636, p=<.001). Increased left ventricular stiffness in HFNEF patients significantly correlated with reduced peak oxygen uptake (r = -0.636, P < .001) and impaired overall exercise capacity.