Right Ventricular Contractile Reserve and Pulmonary Circulation Uncoupling During Exercise Challenge in Heart Failure. Pathophysiology and Clinical Phenotypes

Marco Guazzi, Simona Villani, Greta Generati, Ottavia Eleonora Ferraro, Marta Pellegrino, Eleonora Alfonzetti, Valentina Labate, Maddalena Gaeta, Tadafumi Sugimoto, Francesco Bandera

Research output: Contribution to journalArticle

Abstract

Objectives: Right ventricular (RV) exercise contractile reserve (RVECR), its phenotypes, and its functional correlates are among the unresolved issues with regard to the role of the right ventricle in heart failure (HF) syndrome, and understanding these issues constitutes the objective of this study. Background: Although the role of the right ventricle in HF syndrome might be fundamental, the pathophysiology of the failing right ventricle has not been extensively investigated. Methods: Ninety-seven patients with HF (mean age 64 years, 70% men, mean left ventricular ejection fraction 33 ± 10%) underwent maximal exercise stress echocardiographic and cardiopulmonary exercise testing. RVECR and RV-to-pulmonary circulation (PC) coupling were assessed using the length-force relationship (tricuspid annular plane systolic excursion [TAPSE] vs. pulmonary artery systolic pressure) and the slope of mean pulmonary artery pressure versus cardiac output. On the basis of TAPSE, patients were categorized into 3 groups: those with TAPSE at rest ≥16 mm (group A, n = 60) and those with TAPSE at rest

Original languageEnglish
JournalJACC: Heart Failure
DOIs
Publication statusAccepted/In press - Dec 14 2015

Keywords

  • Exercise
  • Heart failure
  • Pulmonary circulation
  • Right ventricular function

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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