Author + information
- Selma Mohammed,
- Barry Borlaug,
- Steven McNulty,
- Grace Lin,
- Gregory Lewis,
- Rosita Zakeri,
- Marc Semigran,
- Martin LeWinter,
- Adrian Hernandez,
- Eugene Braunwald and
- Margaret Redfield
To elucidate determinants of exercise intolerance in diastolic heart failure (DHF), we related resting LV systolic, LV diastolic and vascular function to peak VO2 (pVO2) in patients participating in RELAX, a multicenter randomized trial of sildenafil® in DHF.
RELAX participants underwent baseline cardiopulmonary exercise testing, echo and MRI (if eligible). Diastolic function was assessed by E/e’ and ordinal diastolic function grade. Systolic function was assessed by EF and stress corrected endocardial and midwall fractional shortening. Vascular function was assessed with echo derived arterial elastance, arterial compliance and systemic vascular resistance and MRI derived aortic distensibility.
RELAX enrolled 216 patients (age 69±10 years; 48% women; BMI 34±8; pVO2 12±3 ml/kg/min; EF 61±8%; E/e’ 19±9). pVO2 was associated with resting diastolic and vascular but not systolic function. However, after adjusting for age and sex, only diastolic function was associated with pVO2. Adjusting for age, sex, and echo derived diastolic, systolic and vascular parameters, only diastolic function (E/e') was independently (p=0.007) associated with pVO2.
Peak exercise capacity is associated with the severity of resting diastolic dysfunction in DHF. While systolic and vascular reserve responses contribute to exercise capacity, resting systolic and vascular function are not independently associated with peak exercise capacity in
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Insights into Diagnosis and Treatment of Heart Failure with Preserved Ejection Fraction
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 1220-277
- 2013 American College of Cardiology Foundation