Pulmonary Vascular Resistance During Exercise Predicts Long-Term Outcomes in Heart Failure With Preserved Ejection Fraction

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dc.citation.issue3
dc.citation.volumev. 24
dc.contributor.authorHuang, Wei
dc.contributor.authorOliveira, Rudolf Krawczenko Feitoza de [UNIFESP]
dc.contributor.authorLei, Han
dc.contributor.authorSystrom, David M.
dc.contributor.authorWaxman, Aaron B.
dc.coveragePhiladelphia
dc.date.accessioned2020-07-20T16:31:20Z
dc.date.available2020-07-20T16:31:20Z
dc.date.issued2018
dc.description.abstractBackground: In heart failure with preserved ejection fraction (HFpEF), the prognostic value of pulmonary vascular dysfunction (PV-dysfunction), identified by elevated pulmonary vascular resistance (PVR) at peak exercise, is not completely understood. We evaluated the long-term prognostic implications of PV-dysfunction in HFpEF during exercise in consecutive patients undergoing invasive cardiopulmonary exercise testing for unexplained dyspnea. Methods: Patients with HFpEF were classified into 2 main groups: resting HFpEF (n = 104, 62% female, age 61 years) with a pulmonary arterial wedge pressure (PAWP) >15 mmHg at resten
dc.description.abstractand exercise HFpEF (eHFpEFen
dc.description.abstractn = 81) with a PAWP <15 mmHg at rest, but >20 mmHg during exercise. The eHFpEF group was further subdivided into eHFpEF + PV-dysfunction (peak PVR 80 dynes/s/cm(-5)en
dc.description.abstractn = 55, 60% female, age 64) group and eHFpEF PV-dysfunction (peak PVR <80 dynes/s/cm(-5)en
dc.description.abstractn = 26, 42% female, age 54 years) group. Outcomes were analyzed for the first 9 years of follow-up and included any cause mortality and heart failure (HF)-related hospitalizations. The mean follow-up time was 6.7 +/- 2.6 years (0.5-9.0). Results: Mortality rate did not differ among the groups. However, survival free of HF-related hospitalization was lower for the eHFpEF + PV-dysfunction group compared with eHFpEF PV-dysfunction (P = .01). These findings were similar between eHFpEF + PV-dysfunction and the resting HFpEF group (P = .774). By Cox analysis, peak PVR >= 80 dynes/s/cm(-5) was a predictor of HF-related hospitalization for eHFpEF (hazard ratio 5.73, 95% confidence interval 1.05-31.22, P = .01). In conclusion, the present study provides insight into the impact of PV-dysfunction on outcomes of patients with exercise-induced HFpEF. An elevated peak PVR is associated with a high risk of HF-related hospitalization.en
dc.description.affiliationChongqing Med Univ, Dept Cardiol, Affiliated Hosp 1, Chongqing, Peoples R China
dc.description.affiliationBrigham & Womens Hosp, Pulm & Crit Care Med, Ctr Pulm Heart Dis, 75 Francis St, Boston, MA 02115 USA
dc.description.affiliationFed Univ Sao Paulo UNIFESP, Div Resp Dis, Dept Med, Sao Paulo, Brazil
dc.description.affiliationUnifespFed Univ Sao Paulo UNIFESP, Div Resp Dis, Dept Med, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipNational Natural Science Foundation of China
dc.description.sponsorshipNatural Science Foundation of Chongqing
dc.description.sponsorshipSao Paulo Research Foundation (FAPESP)
dc.description.sponsorshipBrazilian National Council for Scientific and Technological Development (CNPq)
dc.description.sponsorshipNational Institutes of Health (NIH)
dc.description.sponsorshipIDNNSFC: 81170188
dc.description.sponsorshipIDNNSFC: 30971212
dc.description.sponsorshipIDCSCT: 2009BB5069
dc.description.sponsorshipIDFAPESP: 2014/12212-5
dc.description.sponsorshipIDCNPq: 232643/2014-8
dc.description.sponsorshipIDNIH: U01HL125215
dc.format.extent169-176
dc.identifierhttp://dx.doi.org/10.1016/j.cardfail.2017.11.003
dc.identifier.citationJournal Of Cardiac Failure. Philadelphia, v. 24, n. 3, p. 169-176, 2018.
dc.identifier.doi10.1016/j.cardfail.2017.11.003
dc.identifier.issn1071-9164
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/55883
dc.identifier.wosWOS:000428964100008
dc.language.isoeng
dc.publisherChurchill Livingstone Inc Medical Publishers
dc.relation.ispartofJournal Of Cardiac Failure
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectHeart failure with preserved ejection fractionen
dc.subjectpulmonary vascular dysfunctionen
dc.subjectheart failure hospitalizationen
dc.subjectrisk factoren
dc.titlePulmonary Vascular Resistance During Exercise Predicts Long-Term Outcomes in Heart Failure With Preserved Ejection Fractionen
dc.typeinfo:eu-repo/semantics/article
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