Abstract 17141: Functional Evaluation of Heart Failure With Mid-Range vs Preserved Ejection Fraction by Exercise Gas Exchange Analysis and Stress Echocardiography

Abstract

Introduction: HF patients’ classification has been recently reviewed, with the new-born HF with mid-range ejection fraction class (HFmrEF; EF 40-49%), supposed to have its own clinical and pathophysiology picture. Hypothesis: We aimed to evaluate whether HFmrEF patients exhibit distinctive echocardiographic and functional phenotype in comparison to HF with preserved EF population (HFpEF; EF ≥ 50%). Methods: We performed simultaneously combined exercise stress echocardiography and cardiopulmonary test in 57 HF patients, divided in two cohorts: HFpEF (24 pts: 20 F and 4 M; age 72 + 9) and HFmrEF (33 pts: 12 F and 21 M; age 65,58 + 8,61). Thirty individuals were considered as control group (14 F and 16 M; age 52 + 17). Results: HF groups had enlarged LA (HFpEF p = 0.002; HFmrEF p rest p = 0,026; peak p = 0,044). TAPSE was reduced in HFmrEF, compared to HFpEF ( rest p = 0.002; peak p = 0.038) and controls ( rest and peak p rest HFpEF p = 0.003, HFmrEF p peak HFpEF and HFmrEF p 2 slope - p = 0.002). Conclusions: HFmrEF revealed more pronounced degree of ventricular remodeling, suggesting a progressive evolution from HFpEF. Moreover, HFmrEF had a worse functional profile as suggested by impaired ventilatory efficiency and inability to generate adequate CO at rest, and to improve it during stress test.