Document Detail

Contribution of exercise echocardiography to the diagnosis of heart failure with preserved ejection fraction (HFpEF).
MedLine Citation:
PMID:  20406766     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To examine the contribution of exercise echocardiography (ExE) to the diagnosis of heart failure with preserved ejection fraction (HFpEF).
DESIGN: Cross-sectional study of patients undergoing ExE.
PATIENTS: 436 patients with fatigue or dyspnoea presenting for ExE were studied.
METHODS: Current criteria for the diagnosis of HFpEF (evidence of symptoms or signs of heart failure, EF>50%, abnormal transmitral flow and supplementary tissue Doppler measurements (E/e') suggesting raised left ventricular filling pressure) were applied to this population. The impact of reclassification of clinical status based on exercise E/e' >13 and ischaemia was evaluated.
RESULTS: Of 436 patients, 37 had E/e' >15 and 111 had E/e' 8-15, with supplementary echocardiography criteria indicating HFpEF (n=148). Only 36 patients fulfilling the diagnosis of HFpEF had reduced exercise capacity. Fifteen of these patients had evidence of raised E/e' with exercise, half (7) of whom had inducible myocardial ischaemia. Of 13 patients with raised filling pressure at rest or exercise, objective exercise intolerance and no ischaemia, five did not reach the current criteria for HFpEF.
CONCLUSION: The current classification for HFpEF may include patients with preserved functional status and many with ischaemia and normal exercise E/e'. Reduced exercise capacity, increase of E/e' with exercise and ischaemia are three objective aspects of the HFpEF syndrome that might be considered for incorporation in the definition.
David J Holland; Sandhir B Prasad; Thomas H Marwick
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-04-20
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  96     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-29     Completed Date:  2010-11-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1024-8     Citation Subset:  AIM; IM    
School of Medicine, The University of Queensland, Brisbane, Australia.
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MeSH Terms
Cross-Sectional Studies
Dyspnea / ultrasonography
Exercise Test
Exercise Tolerance / physiology
Fatigue / ultrasonography
Heart Failure, Diastolic / physiopathology*,  ultrasonography*
Middle Aged
Myocardial Ischemia / ultrasonography
Stroke Volume / physiology*
Comment In:
Heart. 2010 Jul;96(13):997-8   [PMID:  20584853 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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