Abstract
ObjectiveSpleen volume increases in patients with advanced heart failure (HF) after left ventricular assist device (LVAD) implantation. However, the relationship between spleen volume and exercise tolerance (peak oxygen consumption [VO2]) in these patients remains unknown. In this exploratory study, we enrolled 27 patients with HF using a LVAD (median age: 46 years). Patients underwent blood testing, echocardiography, right heart catheterization, computed tomography (CT), and cardiopulmonary exercise testing. Spleen size was measured using CT volumetry, and the correlations/causal relationships of factors affecting peak VO2 were identified using structural equation modeling.ResultsThe median spleen volume was 190.0 mL, and peak VO2 was 13.2 mL/kg/min. The factors affecting peak VO2 were peak heart rate (HR; β = 0.402, P = .015), pulmonary capillary wedge pressure (PCWP; β = − 0.698, P = .014), right ventricular stroke work index (β = 0.533, P = .001), blood hemoglobin concentration (β = 0.359, P = .007), and spleen volume (β = 0.215, P = .041). Spleen volume correlated with peak HR, PCWP, and hemoglobin concentration, reflecting sympathetic activity, cardiac preload, and oxygen-carrying capacity, respectively, and was thus related to peak VO2. These results suggest an association between spleen volume and exercise tolerance in advanced HF.
Highlights
Associations between the heart and other organs have been studied to better understand heart failure (HF) pathophysiology [1]
Spleen volume correlated with peak heart rate (HR), pulmonary capillary wedge pressure (PCWP), and hemoglobin concentration, reflecting sympathetic activity, cardiac preload, and oxygen-carrying capacity, respectively, and was related to peak Oxygen consumption (VO2)
These results suggest an association between spleen volume and exercise tolerance in advanced HF
Summary
With SEM, the correlations and causalities of factors that affected peak V O2, including age, male sex, BSA, blood hemoglobin concentration, spleen volume, total CO, peak HR, RAP, RVSWI, PCWP, peak systolic blood pressure, and pump speed (Additional file 2: Table S1 and Additional file 3: Table S2). Five factors significantly affected peak VO2: peak HR (β = 0.402, P = 0.015), PCWP (β = − 0.698, P = 0.014), RVSWI (β = 0.533, P = 0.001), blood hemoglobin concentration (β = 0.359, P = 0.007), and spleen volume (β = 0.215, P = 0.041) (Additional file 2: Table S1; Fig. 2). Spleen volume was associated with peak VO2 through its correlation with peak HR (β = 0.626, P < 0.001), PCWP (β = 0.519, P < 0.001), and blood hemoglobin concentration (β = 0.349, P = 0.047) (Additional file 2: Table S1).
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