Author + information
- Elizabeth A. Hardina,b,
- Michinari Hiedaa,b,
- Erin J. Howdena,b,
- Christopher Hearona,b,
- Satyam Sarmaa,b and
- Benjamin Levinea,b
Background: Rapid saline infusion has been used to assess measures of diastolic function such as cardiac elastance. Studies have shown patients with heart failure and preserved ejection fraction (HFpEF) have significantly higher elastance than controls. We sought to characterize patients with left ventricular hypertrophy (LVH) at high risk for HFpEF by evaluating hemodynamic responses to rapid saline infusion.
Methods: Twelve subjects with LVH and elevated biomarkers (cTnI and/or NT-proBNP) underwent right heart catheterization. Right atrial pressure (RAP) and pulmonary capillary wedge pressure (PCWP) were measured after rapid saline infusion with 15 mL/kg at a rate of 100-200 mL/min. Changes in PCWP and transmural pressure (TMP=PCWP-RAP), relative to volume of saline infused, were compared with age- and sex-matched healthy controls (n=19) and patients with HFpEF (n=10). The slopes were compared among the three groups using a one way ANOVA on ranks and Wilcoxon post-hoc analysis.
Results: The slopes of PCWP and TMP to volume infused in HFpEF patients were markedly elevated when compared to controls (p=0.0003, p=0.008 respectively). Contrary to our expectations, patients with LVH at high risk for HFpEF were no different than controls (p=0.86, p=0.55 respectively).
Conclusions: Patients with structural heart disease at high risk for HFpEF (stage B) do not appear to have exaggerated hemodynamic responses to rapid saline infusion and may be ideal candidates for preventive therapies.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Making Progress in Understanding Heart Failure
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1123-287
- 2017 American College of Cardiology Foundation