Summary:
Introduction: Heart failure is a chronic disease with increased prevalence and incidence. Classification is challenging and recently, a new subtype emerged to clarify limits of diastolic and systolic dysfunction. Use of cardiopulmonary exercise test for classification, diagnosis and treatment of heart failure, is a challenging promising method. Aim: Investigate possible correlation between ergospirometric indicators of cardiopulmonary exercise and parameters (imaging and laboratory) of heart failure with preserved ejection fraction. Study population consists of patients with heart failure with preserved ejection fraction, NYHA classification I-III. Measurements of ergospirometric markers were estimated and correlated with ultrasound parameters of heart failure with preserved ejection fraction and with biomarkers. Specific studies were selected, after relative searched in electronic databases, using related keywords. Results: All studies enforce negative correlation between LAVI (and/or LVMI) with VO2peak, VO2/HR, HRR, exercise time, VO2AT, O2pulse peak, HRmax and METs, and positive correlation between LAVI (and/or LVMI) with VE/VO2slope and BR. The E/A’ shows positive correlation with VO2peak, exercise time and METs, and the E’ positive with VO2peak and HRR, and negative with VE/VCO2slope and PETCO2peak. Similarly, A’ presents positive correlation with VE/VCO2slope and negative with VO2peak and METs. E presents positive with VO2peak, exercise time, O2pulse, PETCO2peak, and VE/VCO2slope and E’ presents positive with BR and VE/VCO2slope and negative with VO2peak, VO2/HR, HRR, exercise time, O2pulse peak, METs and PETCO2. E’ septal and/or Α’ septal, both presenting positive correlations with VO2peak, VO2AT, exercise time, O2pulse peak, and METs. E/e’ presents negative correlation with VO2peak, exercise time, VE/VCO2slope, METs, HRR, HRmax, VO2AT, O2pulse and PETCO2. Finally, e’ presents positive correlation with exercise time, while IVRT negative with METs. Conclusions: Indications of possible correlation between echocardiography parameters and biochemical markers of diastolic preserved ejection fraction heart failure, with ergospirometric parameters of cardiopulmonary exercise test. Specifically, rise of LAVI and/or LVMI, provokes reduction of VO2peak, VO2/HR, HRR, exercise time, VO2AT, O2pulse peak, HRmax and METs, and increase of VE/VCO2slope value. Decrease of E/A, could cause reduction of VO2peak, exercise time and METs, reduction of VO2peak and HRR and rise of VE/VCO2slope and PETCO2peak values. Rise of A’, provokes increase of VE/VCO2slope and reduction of VO2peak and METs. Reduction of E implies depletion of VO2peak, exercise time, O2pulse, PETCO2peak, and VE/VCO2slope, while rise of E/E’, could cause increase of BR and VE/VCO2slope and depletion of VO2peak, VO2/HR, HR, exercise time, O2pulse peak, METs and PETCO2. In addition, decrease of E’ septal and/or A’ septal, could cause depletion of VO2peak, VO2AT, exercise time, O2pulse peak, and METs. Rise of E/e’, could cause depletion of VO2peak, exercise time, VE/VCO2slope, METs, HRR, HRmax, VO2AT, O2pulse and PETCO2. Finally, reduction of e, reflects depletion of exercise time, while increase of IVRT, provokes reduction of METs. Cardiopulmonary exercise test could be a promising method for classification, diagnosis, and treatment monitoring of heart failure patients with preserved ejection fraction. More studies are necessary, to enforce and highlight the method.
