Abstract 14955: Gender And Peak Heart Rate Are Independently Related To Maximal Exercise Capacity In Patients With Diastolic Heart Failure: Results From The Aldo-DHF Trial
Background: There is limited evidence about mechanisms of reduction in exercise capacity in patients with diastolic heart failure (DHF). This study investigated the association of demographics, clinical characteristics, LV structure and function with exercise capacity in patients with DHF.
Methods: In the Aldo-DHF study symptomatic patients (NYHA> II) with proven diastolic dysfunction and preserved left ventricular ejection fraction (LVEF ≥50%) were prospectively included (Aldosterone receptor blockade in diastolic heart failure; Edelmann F et al., Europ J Heart Fail 2010;12:874-882). The trial included up to now 351 patients with DHF. All patients underwent physical and comprehensive echocardiographically examination as well as standardized spiroergometry (bicycle, 20 W stepwise increase of workload).
Results: 351 patients were included: 68.6(±7.9) years old, 49.6% female, BMI 28.9(±3.5)kg/m². NYHA class II 84.7%, NYHA class III 15.3%, mean LVEF 68.2 (±8.1)%. Exercise performance: peak VO2 16.5 (±3.6) ml/kg/min, anaerobic threshold 64.4 (±25.9)W, VO2 at ventilatory anaerobic threshold 11.6 (±3.5) ml/kg/min and maximal workload 101.4 (±28.9) W. Echocardiography: E/e' medial 12.8 (±6.4), DD I° 75.3%, II° 23.4%, III° 0.7%, IV° 0.7%, E-wave 72.1 (±18.5), A-Wave 81.7 (±17.3), e'medial 5.9 (±1,4) and a'medial 9.3 (±1.8). In bivariate correlation analysis E/e' (r=0.187; p=0,001), LVEDV (r=0.224; p<0.001) LVESV (r=0.282; p<0.001) LVESD (r=0.127; p=0,027), age (p=0,001), gender (r-0.56; p<0.001), peak heart rate (r0.247; p<0.001), peak BPsys (r=0.118; p=0.026) and NT-proBNP (r=-0.155; p0.029) were associated with peak VO2. In multiple regression only gender (p<0.001), peak heart rate (p=0.001) remained significantly associated with peak VO2, whereas age, E/é, NT-proBNP, LVEDV and LVESV and peak BPsys did not.
Conclusion: We found that only gender and peak heart rate were independently related to exercise performance in patients with DHF, whereas resting diastolic function and LV geometry did not. This suggests that peak heart rate plays a key role in the reduction of exercise performance in these patients.
- © 2011 by American Heart Association, Inc.