Author + information
- Francesco Bandera,
- Greta Generati,
- Maria Eugenia di Sabato,
- Marta Pellegrino,
- Valentina Labate,
- Eleonora Alfonzetti,
- Serenella Castelvecchio,
- Francesca Giacomazzi,
- Lorenzo Menicanti and
- Marco Guazzi
Right ventricular (RV) dysfunction and RV-pulmonary circulation uncoupling importantly determines clinical course and prognosis in heart failure (HF). Echo-derived pulmonary artery systolic pressure (PASP) and tricuspid annular systolic excursion (TAPSE) are remarkable prognostic markers. We investigated the pulmonary circulation pressure-RV coupling during exercise by looking at the relationship between PASP and TAPSE (rest and peak exercise) in HF patients with exercise oscillatory ventilation (EOV) vs no-EOV.
Methods and Results
16 HF patients (mean age 67.8±8.9; male 31 %) with systolic dysfunction (mean left ventricle EF 32±10%) with no-EOV (n=10) and EOV (n=6) underwent a maximal cardiopulmonary exercise testing evaluation (bike, incremental ramp protocol) combined with Echo-Doppler assessment. Table shows the main Results. Both rest and peak mean PASP/TAPSE ratio in EOV patients resulted worse than the peak ratio in no-EOV, meanings an unfavorable pulmonary pressure- RV function coupling and dynamic pulmonary hypertension.
The abnormal pattern of EOV is associated with a higher degree of pulmonary circulation/RV function uncoupling (PASP/TAPSE ratio) both at rest and peak exercise with a corresponding impaired ventilation efficiency (VE/VC02 slope) and overall exercise performance (peak VO2). These findings provide a rationale for proposing a systematic combined evaluation of Echo-derived RV functional data and gas exchange during exercise.
|Rest||Peak Exercise||Rest||Peak Exercise|
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: New Diagnostic and Imaging Strategies in Heart Failure
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 1136-301
- 2013 American College of Cardiology Foundation