Abstract
Exercise intolerance is the central symptom of heart failure (HF). In the growing subset of patients who have HF with preserved ejection fraction (HFpEF), three main hemodynamic mechanisms accounting for limited exercise capacity have been identified 1 Pandey A. Khera R. Park B. et al. Relative impairments in hemodynamic exercise reserve parameters in heart failure with preserved ejection fraction: a study-level pooled analysis. JACC Heart Fail. 2018; 6: 117-126 Crossref PubMed Scopus (0) Google Scholar ,2 Omote K. Verbrugge F.H. Sorimachi H. et al. Central hemodynamic abnormalities and outcome in patients with unexplained dyspnea. Eur J Heart Fail. 2023; 25: 185-196 Crossref Scopus (6) Google Scholar : (1) chronotropic incompetence, or the inability to achieve an appropriate increase in heart rate during exertion; (2) an excessive rise in pulmonary capillary pressure during exercise; and (3) reduced stroke volume reserve or cardiac output reserve. Similar mechanisms also are contributory in HF with reduced ejection fraction, although the relative importance of each may differ. Other factors, such as impaired oxygen or nutrient uptake by working skeletal muscle, are also believed to be important. 3 Houstis N.E. Eisman A.S. Pappagianopoulos P.P. et al. Exercise intolerance in heart failure with preserved ejection fraction: diagnosing and ranking its causes using personalized O2 pathway analysis. Circulation. 2018; 137: 148-161 Crossref PubMed Scopus (138) Google Scholar The risk of heart failure progression in patients with patent foramen ovale: differential risk associated with device closureJournal of the American Society of EchocardiographyPreviewA patent foramen ovale (PFO) can unload left atrial pressure via an interatrial shunt. We investigated whether device closure of PFO is associated with a subsequent risk of heart failure (HF), particularly in patients with structural heart disease or atrial fibrillation (AF). Full-Text PDF
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