$Relation of microvascular dysfunction and exercise tolerance in patients with heart failure with preserved ejection fraction$

Relation of microvascular dysfunction and exercise tolerance in patients with heart failure with preserved ejection fraction

Purpose We aimed to investigate the association of coronary flow reserve (CFR) with exercise tolerance (ET) in subjects with heart failure with preserved ejection fraction (HFpEF). Materials and Methods Seventy‐seven patients with HFpEF were recruited for the study and compared with 30 healthy match...

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Veröffentlicht in:	Echocardiography (Mount Kisco, N.Y.) N.Y.), 2020-08, Vol.37 (8), p.1192-1198
Hauptverfasser:	Mahfouz, Ragab A., Gouda, Mohammad, Abdelhamid, Mohamed
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Sprache:	eng
Schlagworte:	coronary flow exercise intolerance heart failure
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container_title	Echocardiography (Mount Kisco, N.Y.)
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creator	Mahfouz, Ragab A. Gouda, Mohammad Abdelhamid, Mohamed
description	Purpose We aimed to investigate the association of coronary flow reserve (CFR) with exercise tolerance (ET) in subjects with heart failure with preserved ejection fraction (HFpEF). Materials and Methods Seventy‐seven patients with HFpEF were recruited for the study and compared with 30 healthy matched age and sex controls. All subjects underwent comprehensive echocardiographic evaluation. Exercise tolerance was assessed using 6‐minute walking test (6 MWT). CFR was calculated with adenosine stress transthoracic Doppler echocardiography. Results Out of 77 patients with HFpEF, 51 (66%) had CFR
doi_str_mv	10.1111/echo.14799
format	Article
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Materials and Methods Seventy‐seven patients with HFpEF were recruited for the study and compared with 30 healthy matched age and sex controls. All subjects underwent comprehensive echocardiographic evaluation. Exercise tolerance was assessed using 6‐minute walking test (6 MWT). CFR was calculated with adenosine stress transthoracic Doppler echocardiography. Results Out of 77 patients with HFpEF, 51 (66%) had CFR < 2.0. Patients with CFR < 2.0 had lower 6 MWT distance (P < .001), increased E/e' ratio (P < .001), when compared to HFpEF patients with CFR ≥ 2.0 and controls. In subjects with HFpEF, CFR was significantly correlated with 6 MWTD (P < .001) and inversely correlated with E/e" (P < .01). With univariate analysis, the results showed that left ventricular mass index, left atrial volume index, E/e', and CFR were independent predictors for reduced exercise tolerance, whereas at multivariate analysis, reduced CFR was the only independent predictor (P < .001) for both reduced exercise tolerance in patients with HFpEF. Conclusion The current study demonstrated that reduced CFR was an independent predictor for reduced exercise tolerance in patients with HFpEF. We supposed that microvascular dysfunction has an important role in pathogenesis and clinical course in subjects with HFpEF.]]></description><identifier>ISSN: 0742-2822</identifier><identifier>EISSN: 1540-8175</identifier><identifier>DOI: 10.1111/echo.14799</identifier><identifier>PMID: 32713077</identifier><language>eng</language><publisher>United States</publisher><subject>coronary flow ; exercise intolerance ; heart failure</subject><ispartof>Echocardiography (Mount Kisco, N.Y.), 2020-08, Vol.37 (8), p.1192-1198</ispartof><rights>2020 Wiley Periodicals LLC</rights><rights>2020 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3299-83055cb8a60a1da6b485e4a2c3a1ad60136f4f36db73a6d0362edd8aa6b571693</citedby><cites>FETCH-LOGICAL-c3299-83055cb8a60a1da6b485e4a2c3a1ad60136f4f36db73a6d0362edd8aa6b571693</cites><orcidid>0000-0002-4052-6440 ; 0000-0003-0771-5183</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fecho.14799$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fecho.14799$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27922,27923,45572,45573</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32713077$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mahfouz, Ragab A.</creatorcontrib><creatorcontrib>Gouda, Mohammad</creatorcontrib><creatorcontrib>Abdelhamid, Mohamed</creatorcontrib><title>Relation of microvascular dysfunction and exercise tolerance in patients with heart failure with preserved ejection fraction</title><title>Echocardiography (Mount Kisco, N.Y.)</title><addtitle>Echocardiography</addtitle><description><![CDATA[Purpose We aimed to investigate the association of coronary flow reserve (CFR) with exercise tolerance (ET) in subjects with heart failure with preserved ejection fraction (HFpEF). Materials and Methods Seventy‐seven patients with HFpEF were recruited for the study and compared with 30 healthy matched age and sex controls. All subjects underwent comprehensive echocardiographic evaluation. Exercise tolerance was assessed using 6‐minute walking test (6 MWT). CFR was calculated with adenosine stress transthoracic Doppler echocardiography. Results Out of 77 patients with HFpEF, 51 (66%) had CFR < 2.0. Patients with CFR < 2.0 had lower 6 MWT distance (P < .001), increased E/e' ratio (P < .001), when compared to HFpEF patients with CFR ≥ 2.0 and controls. In subjects with HFpEF, CFR was significantly correlated with 6 MWTD (P < .001) and inversely correlated with E/e" (P < .01). With univariate analysis, the results showed that left ventricular mass index, left atrial volume index, E/e', and CFR were independent predictors for reduced exercise tolerance, whereas at multivariate analysis, reduced CFR was the only independent predictor (P < .001) for both reduced exercise tolerance in patients with HFpEF. Conclusion The current study demonstrated that reduced CFR was an independent predictor for reduced exercise tolerance in patients with HFpEF. We supposed that microvascular dysfunction has an important role in pathogenesis and clinical course in subjects with HFpEF.]]></description><subject>coronary flow</subject><subject>exercise intolerance</subject><subject>heart failure</subject><issn>0742-2822</issn><issn>1540-8175</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kM9LwzAUgIMobk4v_gGSowid-dE27VHGdMJgIHour8kry-jambSbA_94u3V6NJcXku99h4-QW87GvDuPqJf1mIcqTc_IkEchCxKuonMyZCoUgUiEGJAr71eMMcV5eEkGUigumVJD8v2GJTS2rmhd0LXVrt6C120Jjpq9L9pKHz-hMhS_0GnrkTZ1iQ4qjdRWdNNtY9V4urPNki4RXEMLsGXrsH_aOPTottgJVtjbCgfHyzW5KKD0eHOaI_LxPH2fzIL54uV18jQPtBRpGiSSRZHOE4gZcANxHiYRhiC0BA4mZlzGRVjI2ORKQmyYjAUak0BHRorHqRyR-967cfVni77J1tZrLEuosG59JkKhIsEEP6APPdqV8N5hkW2cXYPbZ5xlh9rZoXZ2rN3Bdydvm6_R_KG_eTuA98DOlrj_R5VNJ7NFL_0B9CqNOQ</recordid><startdate>202008</startdate><enddate>202008</enddate><creator>Mahfouz, Ragab A.</creator><creator>Gouda, Mohammad</creator><creator>Abdelhamid, Mohamed</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4052-6440</orcidid><orcidid>https://orcid.org/0000-0003-0771-5183</orcidid></search><sort><creationdate>202008</creationdate><title>Relation of microvascular dysfunction and exercise tolerance in patients with heart failure with preserved ejection fraction</title><author>Mahfouz, Ragab A. ; Gouda, Mohammad ; Abdelhamid, Mohamed</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3299-83055cb8a60a1da6b485e4a2c3a1ad60136f4f36db73a6d0362edd8aa6b571693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>coronary flow</topic><topic>exercise intolerance</topic><topic>heart failure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mahfouz, Ragab A.</creatorcontrib><creatorcontrib>Gouda, Mohammad</creatorcontrib><creatorcontrib>Abdelhamid, Mohamed</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mahfouz, Ragab A.</au><au>Gouda, Mohammad</au><au>Abdelhamid, Mohamed</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relation of microvascular dysfunction and exercise tolerance in patients with heart failure with preserved ejection fraction</atitle><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle><addtitle>Echocardiography</addtitle><date>2020-08</date><risdate>2020</risdate><volume>37</volume><issue>8</issue><spage>1192</spage><epage>1198</epage><pages>1192-1198</pages><issn>0742-2822</issn><eissn>1540-8175</eissn><abstract><![CDATA[Purpose We aimed to investigate the association of coronary flow reserve (CFR) with exercise tolerance (ET) in subjects with heart failure with preserved ejection fraction (HFpEF). Materials and Methods Seventy‐seven patients with HFpEF were recruited for the study and compared with 30 healthy matched age and sex controls. All subjects underwent comprehensive echocardiographic evaluation. Exercise tolerance was assessed using 6‐minute walking test (6 MWT). CFR was calculated with adenosine stress transthoracic Doppler echocardiography. Results Out of 77 patients with HFpEF, 51 (66%) had CFR < 2.0. Patients with CFR < 2.0 had lower 6 MWT distance (P < .001), increased E/e' ratio (P < .001), when compared to HFpEF patients with CFR ≥ 2.0 and controls. In subjects with HFpEF, CFR was significantly correlated with 6 MWTD (P < .001) and inversely correlated with E/e" (P < .01). With univariate analysis, the results showed that left ventricular mass index, left atrial volume index, E/e', and CFR were independent predictors for reduced exercise tolerance, whereas at multivariate analysis, reduced CFR was the only independent predictor (P < .001) for both reduced exercise tolerance in patients with HFpEF. Conclusion The current study demonstrated that reduced CFR was an independent predictor for reduced exercise tolerance in patients with HFpEF. We supposed that microvascular dysfunction has an important role in pathogenesis and clinical course in subjects with HFpEF.]]></abstract><cop>United States</cop><pmid>32713077</pmid><doi>10.1111/echo.14799</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-4052-6440</orcidid><orcidid>https://orcid.org/0000-0003-0771-5183</orcidid></addata></record>
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subjects	coronary flow exercise intolerance heart failure
title	Relation of microvascular dysfunction and exercise tolerance in patients with heart failure with preserved ejection fraction
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