Abstract 15563: Neurovascular Control and Spontaneous Baroreflex Sensitivity in Heart Failure Patients with Preserved Ejection Fraction
Introduction: Muscle sympathetic nerve activity (MSNA) and forearm blood flow (FBF) are markers of mortality in Systolic Heart Failure (S-HF). Endomyocardial Fibrosis (EMF) is a Heart Failure (HF) with Preserved Ejection Fraction (PEF-HF). Although mortality in PEF-HF can be similar to S-HF, it is still unknown if neurovascular control is impaired in PEF-HF.
Hypothesis: Our hypothesis is that even though PEF-HF show normal ejection fraction, they have the same autonomic dysfunction as S-HF. The aim was to evaluate MSNA, FBF and spontaneous baroreflex sensitivity (SBS) in PEF-HF compared to S-HF and healthy subjects (HS).
Methods: Nineteen females HF, NYHA class II and III, were divided in two groups: PEF-HF (n=10) and S-HF (n=9), and were compared to HS (n=7). Left Ventricular Ejection Fraction (LVEF), by echocardiography (Simpson); MSNA, by microneurography; FBF, by venous occlusion plethysmography; mean blood pressure (MBP) and heart rate (HR) by Finometer; SBS, by sequence method, were measured. Significance was considered p<0.05.
Results: Age was not different between PEF-HF, S-HF and HS (57±2 vs. 55±2 vs. 52±1 years; p<0.15, respectively). LVEF was higher in PEF-HF and HS compared to S-HF (55±3 vs. 65±1 vs. 33±2%; p<0.02, respectively). MSNA in bursts per minute (35±3 vs. 40±2 vs. 20±1 bursts/min; p<0.001) and MSNA per 100 heart beats (50±4 vs. 57±3 vs. 26±2 bursts/100 HB; p<0.001) were higher in PEF-HF and S-HF compared to HS, respectively. FBF was lower in PEF-HF and S-HF compared to HS (1.45±0.2 vs. 1.78±0.3 vs. 2.70±0.3 ml/min/100ml; p<0.047). Forearm vascular conductance was lower in PEF-HF compared to HS (1.63±0.2 vs. 2.98±0.3 units; p<0.008) but PEF-HF was not different compared to S-HF (1.63±0.2 vs. 2.04±0.3 units; p<0.28). MBP (92±3 vs. 89±4 vs. 92±4 mmHg; p=0.87) and HR (71±3 to 70±3 vs. 75±3 beats/min; p<0.46) were not different between groups. However, SBS was not different between PEF-HF and S-HF (2.3±0.5 vs. 6.9±4.4 ms/mmHg; p=0.089, respectively) but PEF-HF was lower when compared to HS (2.3±0.5 vs. 8.1±0.7 ms/mmHg; p=0.047, respectively).
Conclusion: These results point out that even though PEF-HF have a normal ejection fraction, they showed neurovascular control as impaired as S-HF with lower SBS compared to HS.
Author Disclosures: A.C. Sayegh: None. M.R. dos Santos: None. F.R. de Souza: None. V.C. Salemi: None. C.P. Oliveira: None. F.X. Fonseca: None. S. Rodrigues: None. I.C. Trombetta: None. E. Toschi-Dias: None. C. Negrão: None. M.N. Alves: None. C. Mady: None.
- © 2014 by American Heart Association, Inc.