Passive leg-lifting in heart failure patients predicts exercise-induced rise in left ventricular filling pressures.
Adult
Aged
Bicycling
Biomarkers
/ blood
Exercise Test
Female
Heart Failure
/ blood
Humans
Male
Middle Aged
Natriuretic Peptide, Brain
/ blood
Peptide Fragments
/ blood
Predictive Value of Tests
Pulmonary Wedge Pressure
Retrospective Studies
Up-Regulation
Ventricular Function, Left
Ventricular Pressure
Elevated filling pressures
Exercise
Heart failure
Passive leg-lifting
Pulmonary hypertension
Journal
Clinical research in cardiology : official journal of the German Cardiac Society
ISSN: 1861-0692
Titre abrégé: Clin Res Cardiol
Pays: Germany
ID NLM: 101264123
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
22
03
2019
accepted:
18
07
2019
pubmed:
2
8
2019
medline:
29
12
2020
entrez:
2
8
2019
Statut:
ppublish
Résumé
The aim of this study was to assess PCWP with passive leg-lifting (PLL) and exercise, in two groups of patients presenting with normal left ventricular ejection fraction (LVEF); one group with elevated NT-proBNP (eBNP), and one with normal NT-proBNP (nBNP) plasma concentration. Fifty-one patients with eBNP (NT-proBNP ≥ 125 ng/l) and LVEF > 50%, were investigated and compared with 34 patients with nBNP (NT-proBNP < 125 ng/l) and LVEF > 50%. Both groups underwent right heart catheterization (RHC) at rest, PLL and exercise. From RHC, mean pulmonary arterial pressure (mPAP), cardiac output (CO), and PCWP were measured. All nBNP patients had PCWP < 15 mmHg at rest, and a PCWP of < 25 mmHg with PLL and during exercise. Patients with eBNP had higher (p < 0.01) resting mPAP, PCWP, and mPAP/CO. These values increased with exercise; however, CO increased less in comparison with nBNP patients (p = 0.001). 20% of patients with eBNP had a PCWP > 15 mmHg at rest, this percentage increased to 47% with PLL and 41% had a PCWP > 25 mmHg during exercise. Of those with PCWP > 25 mmHg during exercise, 91% had a PCWP > 15 mmHg with PLL. A PCWP > 15 mmHg on PLL had a 91% sensitivity and 92% specificity in predicting exercise-induced PCWP of > 25 mmHg. In patients presenting with eBNP, PLL can predict which patients will develop elevated PCWP with exercise. These findings highlight the role of stress assessment.
Identifiants
pubmed: 31368000
doi: 10.1007/s00392-019-01531-w
pii: 10.1007/s00392-019-01531-w
pmc: PMC7098926
doi:
Substances chimiques
Biomarkers
0
Peptide Fragments
0
pro-brain natriuretic peptide (1-76)
0
Natriuretic Peptide, Brain
114471-18-0
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
498-507Références
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