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ORIGINAL ARTICLE
Minerva Cardiology and Angiology 2021 August;69(4):438-45
DOI: 10.23736/S2724-5683.20.05295-0
Copyright © 2020 EDIZIONI MINERVA MEDICA
language: English
Left ventricular concentric remodeling and impaired cardiorespiratory fitness in patients with heart failure and preserved ejection fraction
Justin HEIZER 1, Salvatore CARBONE 1, 2, Hayley E. BILLINGSLEY 1, 2, Benjamin W. VAN TASSELL 3, Ross ARENA 4, Antonio ABBATE 1, Justin M. CANADA 1 ✉
1 VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA; 2 Department of Kinesiology and Health Sciences, College of Humanities and Sciences, Virginia Commonwealth University, Richmond, VA, USA; 3 Department of Pharmacotherapy and Outcome Sciences, Virginia Commonwealth University, Richmond, VA, USA; 4 Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
BACKGROUND: Left ventricular (LV) concentric remodeling refers to a process by which increased LV relative wall thickness alters myocardial geometry, resulting in reduced LV end-diastolic volume (LVEDV) and stroke volume (SV). While the degree of concentric remodeling is a negative prognostic factor in heart failure with preserved ejection fraction (HFpEF), it is not known how it contributes to cardiorespiratory fitness (CRF).
METHODS: We performed a retrospective analysis of patients with HFpEF who underwent treadmill single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) and cardiopulmonary exercise testing (CPX). From exercise SPECT-MPI, we recorded postexercise LVEDVi, LVESVi, SVi, LVEF, the presence and extent of perfusion defects, and perfusion reversibility. Peak oxygen consumption (VO
RESULTS: We identified 23 subjects who had completed both an exercise SPECT-MPI and a CPX. Patients were more commonly women (83%), black (65%), middle age (50 [±7.3] years), and obese (Body Mass Index [BMI] 39.7 [±6.0] kg/m2). Greater LVEDVi and LVESVi correlated positively with peak VO
CONCLUSIONS: Postexercise reduced LV volumes correlate with measures of impaired CRF in patients with HFpEF, thus supporting a pathophysiologic role of concentric remodeling in impaired CRF in HFpEF.
KEY WORDS: Heart failure; Cardiorespiratory fitness; Myocardial perfusion imaging; Oxygen consumption