Fig. 6.

(A) LV (black) and pulmonary wedge (red) pressures at rest in a patient who has symptoms of New York Heart Association class II–III dyspnea and normal LV size and function on echocardiogram. Despite mild to moderate systemic hypertension, cardiac filling pressures are normal, arguing against heart failure. (B) With low-level (40 W) supine exercise in the catheterization laboratory, there is a dramatic increase in cardiac filling pressures (to 45–50 mm Hg) associated with significant dyspnea, suggesting that HFpEF indeed is the cause of the patient’s symptoms.