Abstract：
OBJECTIVE: Emerging evidence suggests that smaller left ventricular volumes may identify subjects with lower cardiorespiratory fitness. Whether left ventricular size predicts functional capacity in patients with heart failure with preserved ejection fraction (HFpEF) is unclear. This study aimed to explore the association between indexed left ventricular end-diastolic volume (iLVEDV) and maximal functional capacity, assessed by peak oxygen consumption (peakVO2), in stable outpatients with HFpEF.
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.
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.
摘要：
目的：新的证据表明，较小的左心室容积可以识别具有较低心肺功能的受试者。左心室大小是否可以预测射血分数保留的心力衰竭（HFpEF）患者的功能容量尚不清楚。本研究旨在探讨左心室舒张末期容积（iLVEDV）与最大功能容量之间的关系。通过峰值耗氧量(峰值VO2)评估，在稳定的HFpEF门诊患者中。
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。
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。
