𧡠New paper in Journal of Cardiac Failure
How does atrial fibrillation affect exercise hemodynamics in HFpEF?
π«π«π΄ =#CPETecho
We combined CPET with echocardiography to dissect the mechanisms π
led by π@S_FoulkesAEP @_Sara_Ferreira @mhaykows π
#HFpEF #AtrialFibrillation
How does atrial fibrillation affect exercise hemodynamics in HFpEF?
π«π«π΄ =#CPETecho
We combined CPET with echocardiography to dissect the mechanisms π
led by π@S_FoulkesAEP @_Sara_Ferreira @mhaykows π
#HFpEF #AtrialFibrillation
1/8
In a large HFpEF cohort undergoing CPETecho, we compared
β’ Sinus rhythm
β’ Paroxysmal AF
β’ Persistent AF
at the time of exercise testing
In a large HFpEF cohort undergoing CPETecho, we compared
β’ Sinus rhythm
β’ Paroxysmal AF
β’ Persistent AF
at the time of exercise testing
2/8π Key finding:
Only persistent #AF was associated with a significantly lower peak VOβ.
Paroxysmal AF behaved much closer to sinus rhythm.
Only persistent #AF was associated with a significantly lower peak VOβ.
Paroxysmal AF behaved much closer to sinus rhythm.
3/8
Why?
The reduction in peak VOβ in persistent AF was driven primarily by:
β¬οΈ Peak cardiac output
β¬οΈ Stroke volume augmentation during exercise
Despite higher HR and similar peripheral Oβ extraction.
#ExercisePhysiology
Why?
The reduction in peak VOβ in persistent AF was driven primarily by:
β¬οΈ Peak cardiac output
β¬οΈ Stroke volume augmentation during exercise
Despite higher HR and similar peripheral Oβ extraction.
#ExercisePhysiology
4/8
Is impaired preload reserve part of the explanation?
Is impaired preload reserve part of the explanation?
5/8
π« Figure 4:
Despite worse exercise capacity, persistent AF showed similar
β’ mPAP
β’ sPAP
β’ mPAP/CO slope
across rhythm groups.
π« Figure 4:
Despite worse exercise capacity, persistent AF showed similar
β’ mPAP
β’ sPAP
β’ mPAP/CO slope
across rhythm groups.
6/8
β Findings were robust after adjustment for
BMI, medications (incl Ξ²-blockers), MR, renal function, and pulmonary hypertension.
β Findings were robust after adjustment for
BMI, medications (incl Ξ²-blockers), MR, renal function, and pulmonary hypertension.
7/8π§ Take-home:
In HFpEF, rhythm at the time of exercise matters.
Rhythm control strategies may therefore be pivotal in optimizing exercise performance and clinical outcomes in patients with HFpEF and AF.
π Journal of Cardiac Failure
In HFpEF, rhythm at the time of exercise matters.
Rhythm control strategies may therefore be pivotal in optimizing exercise performance and clinical outcomes in patients with HFpEF and AF.
π Journal of Cardiac Failure
8/8π Read the full paper: Journal of Cardiac Failure
πThanks to an outstanding team, and to the patients and reviewers
#HFpEF #AtrialFibrillation #CPETecho #ExerciseHemodynamics #CardioTwitterdoi.org/10.1016/j.cardβ¦
πThanks to an outstanding team, and to the patients and reviewers
#HFpEF #AtrialFibrillation #CPETecho #ExerciseHemodynamics #CardioTwitterdoi.org/10.1016/j.cardβ¦
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