ArticleJournal of the American Heart Association2019
Diastolic Ventricular Interaction in Heart Failure With Preserved Ejection Fraction.
Article in Journal of the American Heart Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Sodium-glucose co-transporter 2 inhibitors in heart failure with mildly reduced or preserved ejection fraction: an updated systematic review and meta-analysis.European journal of medical research · 2022Pooled it
- Exercise Training Across the Hypertensive Heart Disease Continuum: Clinical Evidence and Implications for Prescription.Journal of cardiovascular development and disease · 2026Review
- Heart failure with preserved ejection fraction in women: a sex-specific clinical review.The Korean journal of internal medicine · 2026Review
- Comprehensive cardiac magnetic resonance assessment of right ventricular and left atrial function for early diagnosis of heart failure with preserved ejection fraction.European radiology · 2026Article
- Advancing Cardiovascular Risk Stratification and Functional Assessment: A Narrative Review of CPET and ESE Applications.Healthcare (Basel, Switzerland) · 2025Review
- How cardiac output is controlled in a Fontan circulation: an update.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- Novel Strategies in Diagnosing Heart Failure with Preserved Ejection Fraction: A Comprehensive Literature Review.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2024Review
- Use of invasive cardiopulmonary exercise testing to diagnose preload reserve failure in patients with liver disease.ESC heart failure · 2024Article
- Which Diastolic Pressure Should Be Used to Assess Diastolic Function?Anatolian journal of cardiology · 2024Article
- Surgical pericardiotomy to treat heart failure with preserved ejection fraction: a first clinical study.European heart journal · 2023Article
- Efficacy of Ranolazine to Improve Diastolic Performance in Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-analysis.European cardiology · 2023Review
- Dynamic aspects of ventricular interaction during exercise in HFpEF and in pre-capillary pulmonary hypertension.ESC heart failure · 2023Article
- The emerging role of sacubitril/valsartan in pulmonary hypertension with heart failure.Frontiers in cardiovascular medicine · 2023Review
- Exercise testing in heart failure with preserved ejection fraction: an appraisal through diagnosis, pathophysiology and therapy - A clinical consensus statement of the Heart Failure Association and European Association of Preventive Cardiology of the European Society of Cardiology.European journal of heart failure · 2022Article
- Right Heart Phenotype in Heart Failure With Preserved Ejection Fraction.Circulation. Heart failure · 2021Review
- First-in-Human Experience of Mechanical Preload Control in Patients With HFpEF During Exercise.JACC. Basic to translational science · 2021Article
- Altered Hemodynamics and End-Organ Damage in Heart Failure: Impact on the Lung and Kidney.Circulation · 2020Review
- Heart Failure with Preserved Ejection Fraction-a Concise Review.Current cardiology reports · 2020Review
- Biventricular pacemaker therapy improves exercise capacity in patients with non-obstructive hypertrophic cardiomyopathy via augmented diastolic filling on exercise.European journal of heart failure · 2020Article
- Managing heart failure with preserved ejection fraction.Annals of translational medicine · 2020Review
Corrections and comments
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Authors and funding
17 authors at 7 institutions in 1 country.
Funding
Abstract
Background Exercise-induced pulmonary hypertension is common in heart failure with preserved ejection fraction ( HF p EF ). We hypothesized that this could result in pericardial constraint and diastolic ventricular interaction in some patients during exercise. Methods and Results Contrast stress echocardiography was performed in 30 HF p EF patients, 17 hypertensive controls, and 17 normotensive controls (healthy). Cardiac volumes, and normalized radius of curvature ( NRC ) of the interventricular septum at end-diastole and end-systole, were measured at rest and peak-exercise, and compared between the groups. The septum was circular at rest in all 3 groups at end-diastole. At peak-exercise, end-systolic NRC increased to 1.47±0.05 ( P<0.001) in HF p EF patients, confirming development of pulmonary hypertension. End-diastolic NRC also increased to 1.54±0.07 ( P<0.001) in HF p EF patients, indicating septal flattening, and this correlated significantly with end-systolic NRC (ρ=0.51, P=0.007). In hypertensive controls and healthy controls, peak-exercise end-systolic NRC increased, but this was significantly less than observed in HF p EF patients ( HF p EF , P=0.02 versus hypertensive controls; P<0.001 versus healthy). There were also small, non-significant increases in end-diastolic NRC in both groups (hypertensive controls, +0.17±0.05, P=0.38; healthy, +0.06±0.03, P=0.93). In HF p EF patients, peak-exercise end-diastolic NRC also negatively correlated ( r=-0.40, P<0.05) with the change in left ventricular end-diastolic volume with exercise (ie, the Frank-Starling mechanism), and a trend was noted towards a negative correlation with change in stroke volume ( r=-0.36, P=0.08). Conclusions Exercise pulmonary hypertension causes substantial diastolic ventricular interaction on exercise in some patients with HF p EF , and this restriction to left ventricular filling by the right ventricle exacerbates the pre-existing impaired Frank-Starling response in these patients.
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Registered trials
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