Author + information
- Emily Lau,
- Shahrooz Zarbafian,
- Ruslan Ilyasovich,
- John Sbarbaro,
- Robyn Farrell,
- Mark Schoenike,
- Rajeev Malhotra,
- Susan Cheng,
- Mohit Jain,
- Gregory D. Lewis and
- Jennifer Ho
Inflammation has been implicated in the pathobiology of HFpEF. We examined the association of upstream mediators of inflammation as ascertained by eicosanoid metabolites, with exercise manifestations of HFpEF.
We studied 516 participants (mean age 57, 62% women) with chronic dyspnea and preserved LVEF who underwent invasive CPET. We examined the association of 255 eicosanoid metabolites with HFpEF status (n=258, defined as abnormal rest or exercise PCWP) and 6 exercise traits: LV (ΔLVEF) and RV systolic reserve (ΔRVEF), diastolic reserve (ΔPCWP/ΔCO), PV reserve (ΔPAP/ΔCO), peak VO2, and peripheral O2 extraction (C(a-v)O2) using multivariable linear regression and principal components analyses (PCA).
Of 255 eicosanoids, 5 were associated with HFpEF status (FDR q<0.1) and an additional 8 had suggestive associations (P<0.01), with heterogeneous associations across exercise traits (Fig A). Using a PCA vector plot, we found that inflammatory profiles were correlated for the following traits: peak VO2 and peripheral extraction, LV and RV systolic reserve, and diastolic and PV reserve (Fig B). HFpEF status was represented by a unique vector, suggesting contributions from a combination of inflammatory profiles and traits.
Eicosanoids predicted HFpEF status and associated exercise traits among patients with chronic dyspnea and preserved LVEF. Distinct manifestations of exercise intolerance in HFpEF possess unique inflammatory profiles.
Moderated Poster Contributions
Heart Failure and Cardiomyopathies Moderated Poster Theater, Posters, Hall A
Sunday, March 29, 2020, 12:30 p.m.-12:40 p.m.
Session Title: Heart Failure with Preserved Ejection Fraction: Identifying Mechanisms and Targeting Therapy
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1051-03
- 2020 American College of Cardiology Foundation