eCite Digital Repository

Contribution of abnormal central blood pressure to left ventricular filling pressure during exercise in patients with heart failure and preserved ejection fraction

Citation

Holland, DJ and Sacre, JW and Leano, RL and Marwick, TH and Sharman, JE, Contribution of abnormal central blood pressure to left ventricular filling pressure during exercise in patients with heart failure and preserved ejection fraction, Journal of Hypertension, 29, (7) pp. 1422-1430. ISSN 0263-6352 (2011) [Refereed Article]


Preview
PDF
Restricted - Request a copy
352Kb
  

Copyright Statement

Copyright 2011 Lippincott Williams & Wilkins

Official URL: http://www.lww.com/resources/authors/journals-auth...

DOI: doi:10.1097/HJH.0b013e3283480ddc

Abstract

Background Hypertension is ubiquitous in patients with heart failure and preserved ejection fraction (HFpEF) and contributes to arterial and ventricular stiffening. Exertional dyspnea may result from diastolic dysfunction with exercise; however, the association of central bloodpressure (BP) to left ventricular filling pressure during exercise has not been assessed in this population and was the aim of this study. Methods Fifteen patients with HFpEF and 15 age-matched and sex-matched controls were studied at rest, during submaximal and immediately after maximal exercise. Simultaneous echocardiography and radial tonometry was performed to measure E/e and central BP, defined by central augmented pressure (C_AP) and augmentation index (AIx). Results Patients with HFpEF had higher E/e (PU0.020) and peripheral and central BP (P<0.001) at rest, yet similar C_AP and AIx to controls (P>0.05). There was a large increase in E/e with exercise in patients (PU0.012) but no change in C_AP or AIx. Importantly, the change in E/e from rest to submaximal exercise was significantly and independently associated with DC_AP (rU0.559; PU0.030) and DAIx (rU0.654; PU0.008) in patients with HFpEF. In contrast with the controls, E/e, C_AP and AIx decreased with exercise and there were no associations between exercise E/e and central or peripheral BP (P>0.05 for all). Conclusion Indices of central BP are associated with the left ventricular diastolic response to exercise in patients with HFpEF. Arterial function and central hemodynamics may be important targets for treating symptoms associated with raised left ventricular filling pressure with exertion.

Item Details

Item Type:Refereed Article
Keywords:blood pressure, diastolic, exercise, heart failure with preserved ejection fraction, left ventricular
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
Author:Marwick, TH (Professor Tom Marwick)
Author:Sharman, JE (Professor James Sharman)
ID Code:70946
Year Published:2011
Web of Science® Times Cited:11
Deposited By:Menzies Institute for Medical Research
Deposited On:2011-07-05
Last Modified:2014-05-05
Downloads:0

Repository Staff Only: item control page