Evidence of impaired vasodilation during exercise in heart failure with preserved ejection fraction (1156.3)

Abstract

Exercise intolerance is a hallmark characteristic of heart failure (HF), which may be related to impaired exercise‐induced vasodilation in the exercising muscle vasculature. While reductions in exercising limb blood flow have been observed in patients with systolic HF no studies, to date, have evaluated vasodilation in HF patients with preserved ejection fraction (HFpEF) during exercise. Thus, in six HFpEF patients (68±8 yrs) and six age‐ and sex‐matched controls (69±9 yrs), arterial pressure (Finapres) and leg blood flow (LBF; ultrasound Doppler) were assessed during knee‐extension exercise at 0, 5, 10, and 15 W. Resting arterial pressure (HFpEF: 98±2 mmHg; controls: 105±16 mmHg) and LBF (HFpEF: 276±57 mL/min; controls: 299±59 mL/min) were similar between groups. Across work rates, arterial pressure was similar between groups, yet LBF was 30‐40% lower in HFpEF compared to controls (1,256±219 vs. 1,791±151, 1,420±206 vs. 2,102±179, 1,666±91 vs. 2,459±417, and 1,745±206 vs. 2,874±206 mL/min, HFpEF vs. controls at 0, 5, 10, and 15 W, respectively). These data indicate that exercise‐induced vasodilation is markedly impaired in HFpEF patients, which likely contributes to exercise intolerance in this patient population.Grant Funding Source: Supported by NIH PO1 HL‐091830 (R.S.R.) VA RR&D E6910R (R.S.R.) AHA 0835209N (D.W.W)