RESULTS: We prospectively analysed data from 133 consecutive stable outpatients who underwent cardiopulmonary exercise testing and echocardiography on the same day. Data were validated in a cohort of HFpEF patients from San Paolo Hospital, Milan, Italy. A multivariable linear regression assessed the association between iLVEDV and peakVO2. The mean age was 73.2 ± 10.5 years, and 75 (56.4%) were women. The median iLVEDV, indexed left ventricular end-systolic volume, and left ventricular ejection fraction were 46 ml/m2 (30-56), 15 ml/m2 (11-19), and 66% (60-74%), respectively. The median peakVO2 and percentage of predicted peakVO2 were 11 ml/kg/min (9-13) and 64.1% (53-74.4), respectively. Adjusted linear regression analysis showed that smaller iLVEDV was associated with lower peakVO2 (p = 0.0001). In the validation cohort, adjusted linear regression analysis showed a consistent pattern: a smaller iLVEDV was associated with a higher likelihood of reduced peakVO2 (p = 0.004).
CONCLUSIONS: In stable outpatients with HFpEF, a smaller iLVEDV was associated with a lower maximal functional capacity. These findings suggest a need for further studies to understand the pathophysiological mechanisms underlying these observations and to explore targeted treatment strategies for this patient subgroup.
结果:我们前瞻性分析了在同一天接受心肺运动试验和超声心动图检查的133例连续稳定门诊患者的数据。数据在来自圣保罗医院的HFpEF患者队列中进行了验证,米兰,意大利。多元线性回归评估iLVEDV和峰值VO2之间的关联。平均年龄73.2±10.5岁,女性为75人(56.4%)。iLVEDV中位数,左心室收缩末期容积指数,左心室射血分数为46ml/m2(30-56),15ml/m2(11-19),和66%(60-74%),分别。峰值VO2中位数和预测峰值VO2百分比分别为11ml/kg/min(9-13)和64.1%(53-74.4),分别。调整线性回归分析显示,较小的iLVEDV与较低的峰值VO2相关(p=0.0001)。在验证队列中,校正线性回归分析显示了一致的模式:较小的iLVEDV与较高的峰值VO2降低的可能性相关(p=0.004).
结论:在患有HFpEF的稳定门诊患者中,较小的iLVEDV与较低的最大功能容量相关.这些发现表明需要进一步研究以了解这些观察结果的病理生理机制,并探索针对该患者亚组的针对性治疗策略。