Impaired Exercise Tolerance in Heart Failure With Preserved Ejection Fraction: Quantification of Multiorgan System Reserve Capacity.

JACC. Heart Failure
Matthew NayorGregory D Lewis

Abstract

Exercise intolerance is a principal feature of heart failure with preserved ejection fraction (HFpEF), whether or not there is evidence of congestion at rest. The degree of functional limitation observed in HFpEF is comparable to patients with advanced heart failure and reduced ejection fraction. Exercise intolerance in HFpEF is characterized by impairments in the physiological reserve capacity of multiple organ systems, but the relative cardiac and extracardiac deficits vary among individuals. Detailed measurements made during exercise are necessary to identify and rank-order the multiorgan system limitations in reserve capacity that culminate in exertional intolerance in a given person. We use a case-based approach to comprehensively review mechanisms of exercise intolerance and optimal approaches to evaluate exercise capacity in HFpEF. We also summarize recent and ongoing trials of novel devices, drugs, and behavioral interventions that aim to improve specific exercise measures such as peak oxygen uptake, 6-min walk distance, heart rate, and hemodynamic profiles in HFpEF. Evaluation during the clinically relevant physiological perturbation of exercise holds promise to improve the precision with which HFpEF is defined and the...Continue Reading

References

May 1, 1990·Respiration Physiology·J T ReevesC S Houston
Dec 30, 2006·Trends in Cell Biology·Louise L DunnDes R Richardson
May 9, 2007·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Deepak R TalrejaJae K Oh
Nov 5, 2008·Circulation·James J TolleDavid M Systrom
Mar 28, 2009·Journal of the American College of Cardiology·Carolyn S P LamMargaret M Redfield
Mar 28, 2009·The European Respiratory Journal·G KovacsH Olschewski
Feb 23, 2010·Nephron. Clinical Practice·G C KosmadakisJ Feehally
Jun 15, 2010·Circulation. Heart Failure·Barry A BorlaugMargaret M Redfield
Jul 9, 2011·Journal of the American College of Cardiology·Mark J HaykowskyDalane W Kitzman
Oct 8, 2011·European Journal of Heart Failure·Paul S BhellaBenjamin D Levine
Sep 20, 2012·Circulation. Heart Failure·Margaret M RedfieldUNKNOWN Heart Failure Clinical Research Network
Jan 26, 2013·American Journal of Respiratory and Critical Care Medicine·Robert NaeijeGregory D Lewis
Feb 18, 2014·Research Quarterly for Exercise and Sport·Liang HuangSharon Walt
Mar 25, 2014·American Journal of Physiology. Heart and Circulatory Physiology·Dalane W KitzmanMark Haykowsky
Apr 17, 2014·Thorax·Joerg SteierJohn Moxham
Oct 25, 2014·Circulation. Heart Failure·Mads J AndersenBarry A Borlaug
Jan 19, 2016·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Mandeep R MehraUNKNOWN International Society for Heart Lung Transplantation (ISHLT) Heart Failure and Transplantation Council
Apr 3, 2016·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Sherif F NaguehAlan D Waggoner
Oct 4, 2016·The Canadian Journal of Cardiology·Mark J HaykowskyDalane W Kitzman
Jul 8, 2017·Journal of the American College of Cardiology·Yogesh N V ReddyBarry A Borlaug
Jul 15, 2017·Circulation. Heart Failure·Kilian WeissRobert G Weiss
Nov 24, 2017·The European Respiratory Journal·Gabor KovacsHorst Olschewski

❮ Previous
Next ❯

Citations

Sep 11, 2020·Journal of the American Heart Association·Jennifer E Ho
Nov 21, 2020·Heart Failure Reviews·Kristie M HarrisMatthew M Burg
Dec 15, 2020·The Canadian Journal of Cardiology·Mark B BadrovJohn S Floras
Apr 16, 2021·European Respiratory Review : an Official Journal of the European Respiratory Society·Simon MalenfantSteeve Provencher
May 16, 2021·Journal of Cardiac Failure·Michael F CosianoStephen J Greene
Jul 3, 2021·Journal of Clinical Medicine·Álvaro AparisiJ Alberto San Román

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.