In:
American Journal of Physiology-Heart and Circulatory Physiology, American Physiological Society, Vol. 310, No. 1 ( 2016-01-01), p. H4-H13
Abstract:
Preserved ejection fraction heart failure (HFpEF) diagnosis remains controversial, and invasive left ventricular (LV) hemodynamic evaluation and/or exercise testing is advocated by many. The stiffer HFpEF myocardium may show impaired stroke volume (SV) variation induced by fluctuating LV filling pressure during ventilation. Our aim was to investigate spectral transfer function (STF) gain from end-diastolic pressure (EDP) to indexed SV (SV i ) in experimental HFpEF. Eighteen-week-old Wistar-Kyoto (WKY) and ZSF1 lean (ZSF1 Ln) and obese rats (ZSF1 Ob) randomly underwent LV open-chest (OC, n = 8 each group) or closed-chest hemodynamic evaluation (CC, n = 6 each group) under halogenate anesthesia and positive-pressure ventilation at constant inspiratory pressure. Beat-to-beat fluctuations in hemodynamic parameters during ventilation were assessed by STF. End-diastolic stiffness (β i ) and end-systolic elastance (E es i) for indexed volumes were obtained by inferior vena cava occlusion in OC (multibeat) or single-beat method estimates in CC. ZSF1 Ob showed higher EDP spectrum ( P 〈 0.001), higher STF gain between end-diastolic volume and EDP, and impaired STF gain between EDP and SV i compared with both hypertensive ZSF1 Ln and normotensive WKY controls ( P 〈 0.001). Likewise β i was only higher in ZSF1 Ob while E es i was raised in both ZSF1 groups. On multivariate analysis β i and not E es i correlated with impaired STF gain from EDP to SV i ( P 〈 0.001), and receiver-operating characteristics analysis showed an area under curve of 0.89 for higher β i prediction ( P 〈 0.001). Results support further clinical testing of STF analysis from right heart catheterization-derived EDP surrogates to noninvasively determined SV as screening/diagnostic tool to assess myocardial stiffness in HFpEF.
Type of Medium:
Online Resource
ISSN:
0363-6135
,
1522-1539
DOI:
10.1152/ajpheart.00399.2015
Language:
English
Publisher:
American Physiological Society
Publication Date:
2016
detail.hit.zdb_id:
1477308-9
SSG:
12
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