MODERATED POSTER SESSION: Don't look only at the left ventricule: Wednesday 3 December 2014, 09:00-16:00 * Location: Moderated Poster area
Year: 2014
Type: article
Study design: Observational Study
Abstract: Background: Right ventricular (RV) dysfunction at rest has a significant prognostic role in heart failure (HF) syndrome and its combination with pulmonary artery systolic pressure (PASP) is useful for risk stratification.Different response to exercise of echo-derived tricuspid annular systolic excursion (TAPSE) as RV function indicator may provide further clinical stratification in a HF population with advanced bi-ventricular disease.Aim: We aimed to assess RV-pulmonary circulation response to exercise in HF patients with severe RV systolic impairment (TAPSE,16 mm) and to explore the association between RV reserve and exercise capacity as evaluated by cardiopulmonary exercise testing (CPET) combined with echo.Methods: 39 HFrEF patients (mean age 64 y, male 82%, ischemic etiology 64%, LVEF 33 + 10%) underwent a maximal symptoms-limited CPET on a tiltable cycle ergometer (incremental personalized ramp protocol) and exercise echo.Results: Population was divided in two groups according to RV functional reserve (increase of TAPSE at peak exercise .20%).Despite similar bi-ventricular systolic function at rest, patients with impaired RV reserve (Group B) showed lower exercise capacity (peak workload and O 2 pulse), more advanced cardiac remodeling and more severe degree of mitral regurgitation (MR) both at rest and during exercise.Conclusions: In HF patients an impaired RV function at rest may not invariably lead to an unfavorable RV adaptive response to exercise.Testing the degree of RV functional reserve and RV-pulmonary circulation coupling during exercise can be useful even in the most advanced stages of disease to unmask different clinical phenotypes and, very likely, different levels of risk.Abstract P173 Table.Variables Group A (n=17) Group B (n=22) P Rest Peak Rest Peak Rest Peak
DOI: 10.1093/ehjci/jeu243
Authors: G. Generati, F. Bandera, M. Pellegrino, V. Labate, E. Alfonzetti, M. Guazzi, A. Hauck, A. Dragulescu, L. Mertens, M. Friedberg, C. Chrysohoou, J. Kotrogiannis, C. Antoniou, E. Oikonomou, S. Brili, D. Tousoulis, C. Pitsavos, C. Stefanadis, F. Larminaux, O. Huttin, D. Voilliot, V. Manenti, J. Sellal, A. Olivier, S. Carillo, F. Chabot, Y. Juilliere, C. Selton-Suty
Institution: IRCCS Policlinico San Donato
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2332273166