Thread by @kp_rommel

Excited to see our paper in @CircAHA online ahead of 🖨️!

Multimodal approach including #PVloops and #MRI shows differences in physiology between #HFpEF pts w/ ⬆️ vs. ⬇️ LVEF ! - implications for therapy?!

🔑messages in the 🧵 below...

ahajournals.org/doi/10.1161/CI…

1/7

2/7 Problem:

💊responses attenuated in #HFpEF pts w/ ⬆️ versus ⬇️ LVEF.

Differential pathophysiologic considerations elusive.

3/7 Approach:

#HFpEF pts w/ LVEF 50-60% (n=21) and LVEF≥60% (n=35)

Multimodal characterization including #MRI, #PVloops (rest/preload⬇️/🏋️), EBM (in subset).

4/7 Findings (rest):

↔️ LV stroke volumes between groups

LVEF 50-60%:⬆️cardiac dimensions ⬇️RWT ⬇️VAC⬇️ LV contractility

LVEF≥60%: ⬇️fibrosis ⬆️systolic/diastolic stiffness

5/7 Findings (handgrip exercise):

LVEF 50-60%: ⬇️LV contractiliy ⬆️LVEDV ↔️ stroke volumes

LVEF≥60%: ⬆️LV afterload ⬇️LV contractile reserve ⬆️shift of EDPVR⬇️preload reserve ⬇️stroke volumes

6/7 Implications:

🚩Fundamental differences in morphology and physiology btw pts w/ #HFpEF and ⬇️ or⬆️LVEF

↪️ HFpEF-⬇️ LVEF: ⬆️ susceptiblity to 💊 modulation of RAAS / stressed volume

↪️HFpEF-⬆️LVEF: myocardial+arterial stiffness / vascular load as potential treatment 🎯

7/7 A huge thanks to the entire team @leipzig_heart @UniLeipzig @RoschSeb @KP_Kresoja @A_Schoeber@mvonroeder ... @thiele_holger and especially @PhilippLurz

as well as to the great editorial input from @CircAHA by reviewers and @lamcardio

#CardioTwitter #Cardiology

@leipzig_heart @UniLeipzig @RoschSeb @KP_Kresoja @thiele_holger @PhilippLurz @CircAHA @lamcardio @A_Schoeber @mvonroeder