Hypoxaemia in patients with heart failure and preserved ejection fraction.
Gas analysis
Heart failure with preserved ejection fraction
Hypoxaemia
Invasive cardiopulmonary exercise test
Outcome
Journal
European journal of heart failure
ISSN: 1879-0844
Titre abrégé: Eur J Heart Fail
Pays: England
ID NLM: 100887595
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
revised:
06
06
2023
received:
27
12
2022
accepted:
07
06
2023
medline:
23
10
2023
pubmed:
15
6
2023
entrez:
15
6
2023
Statut:
ppublish
Résumé
It is widely held that heart failure (HF) does not cause exertional hypoxaemia, based upon studies in HF with reduced ejection fraction, but this may not apply to patients with HF and preserved ejection fraction (HFpEF). Here, we characterize the prevalence, pathophysiology, and clinical implications of exertional arterial hypoxaemia in HFpEF. Patients with HFpEF (n = 539) and no coexisting lung disease underwent invasive cardiopulmonary exercise testing with simultaneous blood and expired gas analysis. Exertional hypoxaemia (oxyhaemoglobin saturation <94%) was observed in 136 patients (25%). As compared to those without hypoxaemia (n = 403), patients with hypoxaemia were older and more obese. Patients with HFpEF and hypoxaemia had higher cardiac filling pressures, higher pulmonary vascular pressures, greater alveolar-arterial oxygen difference, increased dead space fraction, and greater physiologic shunt compared to those without hypoxaemia. These differences were replicated in a sensitivity analysis where patients with spirometric abnormalities were excluded. Regression analyses revealed that increases in pulmonary arterial and pulmonary capillary pressures were related to lower arterial oxygen tension (PaO Between 10% and 25% of patients with HFpEF display arterial desaturation during exercise that is not ascribable to lung disease. Exertional hypoxaemia is associated with more severe haemodynamic abnormalities and increased mortality. Further study is required to better understand the mechanisms and treatment of gas exchange abnormalities in HFpEF.
Substances chimiques
Oxygen
S88TT14065
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1593-1603Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL128526
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL162828
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL160226
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2023 European Society of Cardiology.
Références
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