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19. Betablockers reduce oxygen pulse increase and performance in heart failure patients with preserved ejection fraction

Author

Wernhart, Simon, Papathanasiou, Maria, Mahabadi, Amir Abbas, Rassaf, Tienush, and Lüdike, Peter

Subjects
Medizin, Cardiology and Cardiovascular Medicine
Abstract

Beta blockers (BB) reduce chronotropic response and exercise capacity in heart failure with preserved ejection fraction (HFpEF). To analyze the influence of BB on exercise performance and O 2 pulse increase as a surrogate for stroke volume in HFpEF.We retrospectively analyzed the influence of BB intake (yes: n = 48/no: n = 51) on peak oxygen uptake (VO 2peak), oxygen uptake efficiency slope (OUES), and increase of O 2 pulse in HFpEF patients undergoing cardiopulmonary exercise testing (CPET). Associations of outcome variables and risk category of the algorithm of the Heart Failure Association of the European Society of Cardiology (HFA-PEFF score) were calculated.Patients on BB showed lower VO 2peak (p = .003) and OUES (p = .002), with a dominant effect in the high-risk (p = .020; 0.002), but not in the low risk-group (p = .434; p = .499). In the intermediate group BB showed a trend towards lower VO 2peak (p = .078) and lower values for OUES (p = .020). Patients on BB also demonstrated a lower increase of O 2 pulse during exercise (p = .002), without differences between HFA-PEFF risk groups (low: p = .322, intermediate: p = .269, high: p = .313).BB reduce exercise capacity and O 2 pulse increase in HFpEF patients. Direct quantification of O 2 pulse increase may help to improve the discrimination of HFpEF patients.

Published
2022

22. Exercise oscillatory ventilation in patients with advanced heart failure with and without left ventricular assist device.

Author

Wernhart, Simon, Papathanasiou, Maria, Jakstaite, Aiste, Hoffmann, Julia, Schmack, Bastian, Hedderich, Jürgen, Ruhparwar, Arjang, Rassaf, Tienush, and Luedike, Peter

Subjects
*HEART assist devices, *HEART failure patients, *EXERCISE tests, *NEUROENDOCRINE cells, *AORTIC valve, *AEROBIC capacity, *CARDIAC catheterization, *TRANSCRANIAL magnetic stimulation
Abstract

Background: Exercise oscillatory ventilation (EOV), indicating pathological fluctuations on pulmonary arterial pressure, is associated with mortality in patients with heart failure (HF). Whether left ventricular assist device (LVAD)‐induced ventricular unloading can reverse EOV and may prevent short‐term rehospitalization has not been investigated. Methods: We performed a retrospective single‐center in‐ and outpatient analysis of patients with (n = 20, LVAD) and without (n = 27, HF) circulatory support and reduced ejection fraction (EF, 22.8 ± 7.9%). The association of cardiopulmonary exercise testing (CPET) variables and 3 months‐rehospitalization (3MR) as a primary outcome was analyzed. Furthermore, CPET variables were compared regarding the presence of EOV (+/−). Results: Lower VO2peak (11.6 ± 4.9 ml/kg/min vs. 14.4 ± 4.3 ml/kg/min, p = 0.039), lower increase of PETCO2 (CI = 0.049–1.127; p = 0.068), and higher VE/VCO2 (43.8 ± 9.5 vs. 38.3 ± 10.6; p = 0.069) were associated with 3MR. Flattening of O2 pulse (CI = 0.139–2.379; p = 0.487) had no impact on 3MR. EOV was present in 59.5% (n = 28/47) of patients, without a significant difference between LVAD and HF patients (p = 0.959). Patients with HF/EOV+ demonstrated significantly lower VO2peak compared with HF/EOV− (p = 0.039). LVAD/EOV+ displayed significantly lower EF (p = 0.004) and fewer aortic valve opening than LVAD/EOV− (p = 0.027). Conclusions: Lower VO2peak, but not EOV, was associated with 3MR. EOV occurred at a similar rate in LVAD and HF patients, which may illustrate insufficient unloading during exercise in chronic LVAD therapy and may contribute to the limited exercise capacity following LVAD implantation. Simultaneous CPET and right heart catheterization studies are needed to elucidate whether EOV may serve as a non‐invasive predictor of insufficient LV unloading necessitating LVAD reprograming. [ABSTRACT FROM AUTHOR]

Published
2023
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23. sj-docx-1-cvd-10.1177_20480040211047742 - Supplemental material for Reduced physical activity and weight gain are associated with an increase of depressive symptoms during the COVID-19 pandemic. A general practitioners’ prospective observational study

Author

Wernhart, Simon, Weihe, Eberhard, and Rassaf, Tienush

Subjects
Cardiology
Abstract

Supplemental material, sj-docx-1-cvd-10.1177_20480040211047742 for Reduced physical activity and weight gain are associated with an increase of depressive symptoms during the COVID-19 pandemic. A general practitioners’ prospective observational study by Simon Wernhart, Eberhard Weihe and Tienush Rassaf in JRSM Cardiovascular Disease

Published
2021
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24. sj-docx-3-cvd-10.1177_20480040211047742 - Supplemental material for Reduced physical activity and weight gain are associated with an increase of depressive symptoms during the COVID-19 pandemic. A general practitioners’ prospective observational study

Author

Wernhart, Simon, Weihe, Eberhard, and Rassaf, Tienush

Subjects
Cardiology
Abstract

Supplemental material, sj-docx-3-cvd-10.1177_20480040211047742 for Reduced physical activity and weight gain are associated with an increase of depressive symptoms during the COVID-19 pandemic. A general practitioners’ prospective observational study by Simon Wernhart, Eberhard Weihe and Tienush Rassaf in JRSM Cardiovascular Disease

Published
2021
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25. sj-docx-2-cvd-10.1177_20480040211047742 - Supplemental material for Reduced physical activity and weight gain are associated with an increase of depressive symptoms during the COVID-19 pandemic. A general practitioners’ prospective observational study

Author

Wernhart, Simon, Weihe, Eberhard, and Rassaf, Tienush

Subjects
Cardiology
Abstract

Supplemental material, sj-docx-2-cvd-10.1177_20480040211047742 for Reduced physical activity and weight gain are associated with an increase of depressive symptoms during the COVID-19 pandemic. A general practitioners’ prospective observational study by Simon Wernhart, Eberhard Weihe and Tienush Rassaf in JRSM Cardiovascular Disease

Published
2021
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27. sj-pdf-3-cvd-10.1177_2048004020973834 - Supplemental material for Prediction of pulmonary hypertension in older adults based on vital capacity and systolic pulmonary artery pressure

Author

Wernhart, Simon and Hedderich, Jürgen

Subjects
Cardiology
Abstract

Supplemental material, sj-pdf-3-cvd-10.1177_2048004020973834 for Prediction of pulmonary hypertension in older adults based on vital capacity and systolic pulmonary artery pressure by Simon Wernhart and Jürgen Hedderich in JRSM Cardiovascular Disease

Published
2020
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28. sj-pdf-2-cvd-10.1177_2048004020973834 - Supplemental material for Prediction of pulmonary hypertension in older adults based on vital capacity and systolic pulmonary artery pressure

Author

Wernhart, Simon and Hedderich, Jürgen

Subjects
Cardiology
Abstract

Supplemental material, sj-pdf-2-cvd-10.1177_2048004020973834 for Prediction of pulmonary hypertension in older adults based on vital capacity and systolic pulmonary artery pressure by Simon Wernhart and Jürgen Hedderich in JRSM Cardiovascular Disease

Published
2020
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