Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Beyond Beats: an analysis of hemodynamics and exercise capacity in Heart Failure patients with Atrial Fibrillation
Session:
Sessão de Posters 33 - Insuficiência cardíaca - Avaliação de exercício
Speaker:
Ana Rita Teixeira
Congress:
CPC 2024
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.6 Chronic Heart Failure - Clinical
Session Type:
Cartazes
FP Number:
---
Authors:
Ana Rita Teixeira; Sofia Jacinto; João Ferreira Reis; Pedro Brás; António Valentim Gonçalves; Rita Ilhão Moreira; Tiago Pereira-Da-Silva; Ana Teresa Timóteo; Rui Cruz Ferreira
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt"><span style="background-color:white"><span style="color:black">Background:</span></span></span></strong><span style="font-size:11.0pt"><span style="background-color:white"><span style="color:black"> The coexistence of atrial fibrillation (AF) with Heart Failure (HF) complicates clinical management and is associated with increased mortality. This study aims to compare cardiopulmonary exercise testing (CPET) and right heart catheterization (RHC) parameters in HF patients with AF versus sinus rhythm (SR) and its prognostic importance. </span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Methods:</span></strong><span style="font-size:11.0pt"> A prospective single-center study included HF patients (pts) with left ventricular ejection fraction (LVEF) ≤40%, grouped by AF presence. All pts underwent both CPET and RHC to assess physiological and hemodynamic parameters. <span style="color:black">Data analysis used chi-square and independent t-tests. <span style="background-color:white">Univariate and multivariate Cox analyses identified predictors for the primary endpoint (cardiac death or urgent heart transplant), </span>with significance at p<0.05.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt"><span style="color:black">Results:</span></span></strong><span style="font-size:11.0pt"><span style="color:black"> A total of 110 pts were enrolled, 33 in the AF group. Table 1 presents baseline characteristics of both groups. Regarding clinical data, AF pts were older and more symptomatic. There were also differences in HF survival score and cardiac resynchronization therapy prevalence. Right ventricular dysfunction (27.3% vs 51.5%, p=0.014) and LVEF ≤ 20% (14.3%, 36.4% p=0.009)<strong> </strong>were more frequent in the AF group, revealing worse biventricular function<span style="background-color:white">.</span> <span style="background-color:white">CPET data showed no differences regarding heart rate parameters, but it revealed worse status in AF pts, including lower CPET duration, pVO<sub>2</sub>, time to anaerobic threshold (AT), and higher VE/VCO2 slope (table 2). RHC parameters demonstrated a mean pulmonary artery pressure (PAP) suggestive of pulmonary hypertension, higher systolic and diastolic PAP, and right atrial pressure and lower PAPi values in the presence of AF. Yet, no significant differences in PAPi values predicting RV failure. </span></span></span><span style="font-size:11.0pt"><span style="color:black">At 2 years, the primary endpoint significantly differed between groups (<em>p</em>=0.031), indicating that AF pts experienced a more unfavorable prognosis. </span></span><span style="font-size:11.0pt"><span style="background-color:white"><span style="color:black">Peak pVO<sub>2</sub>, and VE/VCO<sub>2</sub> slope were primary endpoint predictors; in the multivariate analysis pVO2 was the only independent one (p=0.009).</span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Conclusion: </span></strong><span style="font-size:11.0pt">The observed differences in CPET and RHC parameters suggest that AF distinctly impacts exercise capacity and hemodynamic profiles in HF pts. Prognostic CPET measures, such as pVO<sub>2</sub> and VE/VCO<sub>2</sub> slope, showed worse status in AF pts, being pVO<sub>2</sub> an independent predictor of cardiac death/heart transplant. </span></span></span></p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site