Pulmonary Vascular Pressures and Gas Exchange Response to Exercise in Heart Failure With Preserved Ejection Fraction

Fermoyle, Caitlin C.; Stewart, Glenn M.; Borlaug, Barry A.; Johnson, Bruce D.

doi:10.1016/j.cardfail.2020.07.009

Cited by 2 publications

(11 citation statements)

References 16 publications

(22 reference statements)

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“…The 27 selected studies 2 , 3 , 4 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 included 2180 HFpEF patients and 682 controls. Characteristics of individual studies are reported in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Characteristics of individual studies are reported in Table 1 . Thirteen studies (48%) had a prospective design, 3 , 4 , 17 , 19 , 23 , 25 , 26 , 27 , 29 , 30 , 31 , 34 13 (48%) were retrospective, 2 , 13 , 14 , 15 , 18 , 20 , 21 , 22 , 24 , 28 , 33 , 35 , 36 and 1 study (4%) was a randomized controlled trial. 32 …”

Section: Resultsmentioning

confidence: 99%

“…Of the 27 selected studies, 17 were performed in three centres of the United States, 2 , 3 , 4 , 13 , 14 , 15 , 16 , 17 , 18 , 21 , 24 , 26 , 28 , 30 , 33 , 34 , 36 5 in one Australian centre, 19 , 22 , 25 , 27 , 31 and 2 in Europe. 29 , 35 Three studies were multicentric, with patients coming from American, Australian, and European centres.…”

Section: Resultsmentioning

confidence: 99%

“… 2 , 17 , 23 , 30 , 33 , 34 , 36 CO was measured by direct Fick method in most studies ( n = 16, 59%). 2 , 3 , 4 , 13 , 14 , 15 , 16 , 17 , 18 , 21 , 23 , 24 , 26 , 28 , 30 , 36 …”

Section: Resultsmentioning

confidence: 99%

“…Because there were more cohort studies per centre with overlapped recruitment period, we performed a sensitivity analysis including only one cohort per centre 3 , 4 , 17 , 21 , 22 , 26 , 27 , 28 , 30 , 34 to verify the robustness of results. As shown in Table S10 , summary point and interval estimates of each exercise haemodynamic variable in this subset of studies were comparable with those obtained on the entire dataset.…”

Section: Resultsmentioning

confidence: 99%

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Exercise haemodynamics in heart failure with preserved ejection fraction: a systematic review and meta‐analysis

et al. 2022

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Aims Exercise right heart catheterization (RHC) is considered the gold-standard test to diagnose heart failure with preserved ejection fraction (HFpEF). However, exercise RHC is an insufficiently standardized technique, and current haemodynamic thresholds to define HFpEF are not universally accepted. We sought to describe the exercise haemodynamics profile of HFpEF cohorts reported in literature, as compared with control subjects. Methods and resultsWe performed a systematic literature review until December 2020. Studies reporting pulmonary artery wedge pressure (PAWP) at rest and peak exercise were extracted. Summary estimates of all haemodynamic variables were evaluated, stratified according to body position (supine/upright exercise). The PAWP/cardiac output (CO) slope during exercise was extrapolated. Twenty-seven studies were identified, providing data for 2180 HFpEF patients and 682 controls. At peak exercise, patients with HFpEF achieved higher PAWP (30 [29-31] vs. 16 [15-17] mmHg, P < 0.001) and mean right atrial pressure (P < 0.001) than controls. These differences persisted after adjustment for age, sex, body mass index, and body position. However, peak PAWP values were highly heterogeneous among the cohorts (I 2 = 93%), with a relative overlap with controls. PAWP/CO slope was steeper in HFpEF than in controls (3.75 [3.20-4.28] vs. 0.95 [0.30-1.59] mmHg/L/min, P value < 0.0001), even after adjustment for covariates (P = 0.007). Conclusions Despite methodological heterogeneity, as well as heterogeneity of pooled haemodynamic estimates, the exercise haemodynamic profile of HFpEF patients is consistent across studies and characterized by a steep PAWP rise during exercise. More standardization of exercise haemodynamics may be advisable for a wider application in clinical practice.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“… 2 , 17 , 23 , 30 , 33 , 34 , 36 CO was measured by direct Fick method in most studies ( n = 16, 59%). 2 , 3 , 4 , 13 , 14 , 15 , 16 , 17 , 18 , 21 , 23 , 24 , 26 , 28 , 30 , 36 …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Exercise haemodynamics in heart failure with preserved ejection fraction: a systematic review and meta‐analysis

et al. 2022

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U-Shaped Association between Serum Chloride Levels and In-Hospital Mortality in Patients with Congestive Heart Failure in Intensive Care Units

Zhang,

Han,

et al. 2024

Int. Heart J.

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Serum chloride level has clinical significance in the prognosis of heart failure. Little is known regarding the association between serum chloride levels and in-hospital mortality in patients with heart failure.This retrospective study used clinical data obtained from the Medical Information Mart for Intensive Care Database. The study cohort comprised patients who were categorized on the basis of their serum chloride levels, and the primary endpoint was in-hospital mortality. To assess the impact of serum chloride levels at the time of intensive care unit admission on in-hospital mortality, we used various statistical approaches, including multivariable logistic regression models, a generalized additive model, and a two-piecewise linear regression model. In addition, subgroup analysis was conducted to examine the robustness of the main findings.This study comprised 15,983 participants. When compared with the reference group (Q5), the groups with the highest (Q7) and lowest (Q1) blood chloride levels exhibited increased in-hospital mortality, with fully adjusted odds ratios (ORs) of 1.36 [95% confidence interval (CI): 1.08-1.71] and 1.25 (95% CI: 1-1.56), respectively. A U-shaped relationship was observed between blood chloride levels and in-hospital mortality, with the lowest risk observed at a threshold of 105.017 mmol/L. The effect sizes and corresponding CIs below and above the threshold were 0.969 (95% CI: 0.957-0.982) and 1.039 (95% CI: 1.002-1.076), respectively. Stratified analyses demonstrated the robustness of this correlation.The relationship between serum chloride levels and in-hospital mortality in patients with heart failure was U-shaped, with an inflection point of 105.017 mmol/L.

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Pulmonary Vascular Pressures and Gas Exchange Response to Exercise in Heart Failure With Preserved Ejection Fraction

Cited by 2 publications

References 16 publications

Exercise haemodynamics in heart failure with preserved ejection fraction: a systematic review and meta‐analysis

Exercise haemodynamics in heart failure with preserved ejection fraction: a systematic review and meta‐analysis

U-Shaped Association between Serum Chloride Levels and In-Hospital Mortality in Patients with Congestive Heart Failure in Intensive Care Units

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