Rapid Fire Abstracts
Sören Backhaus, MD
Consultant Cardiologist
Department of Cardiology, Heart Centre, Kerckhoff-Clinic Bad Nauheim, Germany
Sören Backhaus, MD
Consultant Cardiologist
Department of Cardiology, Heart Centre, Kerckhoff-Clinic Bad Nauheim, Germany
Alexander Schulz, MD
Dr.
Harvard Medical School / BIDMC, Germany
Torben Lange, MD
Resident
University Medical Center Göttingen, Germany, Germany
Simon Rösel, BA
Medical Student
University Hospital Göttingen, Germany
Lennart Schmidt-Schweda, BA
Medical Student
University Hospital Göttingen, Germany
Shelby Kutty, MD
Dr.
Taussig Heart Center, USA
Johannes Kowallick, MD
Prof.
University Medical Center Göttingen, Germany, Germany
Julia Treiber, MD
senior physician
Kerckhoff Klinik, Germany
Andreas Rolf, MD
Senior Cardiologist
Kerckhoff Klinikum Bad Nauheim, Germany
Samuel Sossalla, MD
chief medical officer
Kerckhoff Klinik, Germany
Gerd Hasenfuß, MD
Prof
University Medical Center Göttingen, Germany, Germany
Andreas Schuster, MD, PhD
Cardiologist
University Medical Center Göttingen, Germany
Latent pulmonary vascular disease is a distinct feature already in the early pathophysiology of masked heart failure with preserved ejection fraction (HFpEF) and associated with reduced right ventricular (RV) functional reserve. We hypothesized that serial real-time cardiovascular magnetic resonance (CMR) imaging at rest and during exercise-stress may detect early progress in pathophysiological alterations in HFpEF.
Methods:
Patients presenting with exertional dyspnoea and signs of diastolic dysfunction (E/e’ >8, left ventricular (LV) ejection fraction >50%) were prospectively enrolled in the HFpEF Stress Trial (NCT03260621). Rest and exercise-stress echocardiography, CMR and right heart catheterisation (RHC) were performed at baseline. RHC-derived pulmonary capillary wedge pressure (PCWP) was used for classification of HFpEF (≥15/25mmHg at rest/during exercise-stress) and non-cardiac dyspnoea (NCD). Repeat rest and exercise-stress CMR was performed in median 2.94 years after recruitment during which timeframe some HFpEF patients had undergone interatrial shunt device (IASD) implantation. Cardiovascular events were assessed after 4 years.
Results:
Serial CMR scans were available for NCD n=10, HFpEF n=10 and HFpEF with IASD implantation following baseline diagnosis n=6. RV LAS at rest and during exercise-stress decreased in HFpEF (p=0.007 for both) but neither in NCD nor HFpEF with IASD. In contrast, in NCD, an improvement in LA LAS during exercise-stress (p=0.028) was noted. There were no functional alterations in HFpEF patients who had undergone IASD implantation.
Conclusion:
RV functional deterioration may be a pathophysiological feature during early-stage disease progress in HFpEF. In this observational study RV functional deterioration was detected in HFpEF patients only but not patients with NCD and patients with HFpEF that were treated with IASD placement. These findings should next be explored in adequately powered future prospective research trials.
