Medizinische Universität Graz - Research portal

Go directly to the nagivation.
Go directly to the content.

Navigation/Search

Selected Publication:

Broufa, M.
PULSATILE HEMODYNAMICS AND EXERCISE CAPACITY-FOCUS ON HEART FAILURE WITH PRESERVED EJECTION FRACTION
Doktoratsstudium der Medizinischen Wissenschaft; Humanmedizin; [ Dissertation ] Graz Medical University; 2018. pp. 98 [OPEN ACCESS]
FullText

Authors Med Uni Graz:
Advisor:: Holasek Sandra Johanna; Zweiker Robert
Altmetrics:
Abstract:: BACKGROUND: Pulsatile hemodynamics are associated with left ventricular filling pressures and diastolic dysfunction. Increased values can be detected in many patients with heart failure with preserved ejection fraction (EF). The relationship with objective measurements of exercise capacity remains largely unknown. We investigated their relationship with maximum workload and peak oxygen uptake (peak VO2) in patients with exertional dyspnea, normal pulmonary function and preserved ejection fraction (EF). METHODS: Radial waveforms were acquired with tonometry and processed with a transfer function to derive central aortic pressures. Pulse wave analysis and wave separation analysis yielded estimates of forward waves (Pf) and wave reflection (Augmentation Index-AIx, Augmentation Pressure-AP, backward wave amplitude-Pb). Aortic pulse wave velocity (aoPWV) was estimated with a validated formula from single-point waveforms. A bicycle ergometer using a ramp protocol was chosen for ergospirometry. RESULTS: 66 patients were included (43 females; mean age 66 years; 83 % hypertensives; mean body mass index-BMI 28.3 kg/m2). VO2max was 17.0 mL/min/kg, mean achieved maximum workload 110 watts (89 % of a reference population). Maximum workload and peak VO2 showed significant inverse relationships with AIx, AP, Pb, and aoPWV (r=-0.26 - -0.53). In multiple adjusted regression models, AP, Pf, Pb, brachial and aortic pulse pressure (PP), and aoPWV were significant independent predictors of maximum workload. CONCLUSIONS: Pulsatile hemodynamics are independently associated with objective measures of exercise capacity in patients with normal EF.