Document Detail

Increased atrial contribution to left ventricular filling compensates for impaired early filling during exercise in heart failure with preserved ejection fraction.
MedLine Citation:
PMID:  19944366     Owner:  NLM     Status:  In-Process    
BACKGROUND: The role of left atrial (LA) function on exercise remains poorly understood in heart failure with preserved ejection fraction (HfpEF) despite its key role in optimizing left ventricular (LV) diastolic function. We used resting and exercise radionuclide ventriculography to investigate the role of LA function in the pathophysiology of HfpEF. METHODS AND RESULTS: A total of 25 patients with HfpEF and 15 age- and gender-matched controls were recruited. All subjects underwent resting echocardiogram, metabolic exercise testing to peak effort, and radionuclide ventriculography (at rest and exercise [to 35% of heart rate reserve]). At rest LA and LV function were similar in patients and controls. During exercise, HfpEF patients had lower left ventricular ejection fraction (69 +/- 9% vs. 73 +/- 10%, P < .05) and lower peak early filling rate (387 +/- 109 end-diastolic count/sec vs. 561 +/- 156 end-diastolic count/sec, P < .001). During exercise, the atrial contribution to LV filling was significantly higher in patients than controls (46 +/- 11% vs. 30 +/- 9%, P < .001). Atrial contribution to LV filling correlated negatively with peak early filling rate during exercise (r = -0.6, P < .001). Peak early filling rate correlated positively with peak oxygen consumption (r = 0.485, P = .004) and negatively with minute/carbon dioxide production (r = -0.423, P = .013). CONCLUSION: Patients with HfpEF have increased atrial contribution to LV filling as a compensatory response to impaired early LV filling during cycle exercise.
Thanh T Phan; Khalid Abozguia; Ganesh Nallur Shivu; Ibrar Ahmed; Francisco Leyva; Kiran Patel; Michael Frenneaux
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-08-05
Journal Detail:
Title:  Journal of cardiac failure     Volume:  15     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  890-7     Citation Subset:  IM    
Department of Cardiovascular Medicine, University of Birmingham, Edgbaston, Birmingham, UK.
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Grant Support
//British Heart Foundation

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

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