Table 3.
Invasive Hemodynamics at Rest and during Exercise
| Controls (n=71) |
Non-obese HFpEF (n=96) |
Obese HFpEF (n=99) |
P value | |
|---|---|---|---|---|
| Rest | ||||
|
| ||||
| Vital signs | ||||
| Heart rate (bpm) | 64±13 | 65±13 | 64±12 | 0.9 |
| Systolic BP (mmHg) | 143±27 | 152±30 | 148±31 | 0.3 |
| Mean BP (mmHg) | 97±15 | 102±17 | 99±18 | 0.4 |
|
| ||||
| Central pressures | ||||
| RA pressure (mmHg) | 4±2 | 8±3* | 11±5*† | <0.0001 |
| PA systolic pressure (mmHg) | 29±8 | 40±12* | 41±13* | <0.0001 |
| PA mean pressure (mmHg) | 16±4 | 26±8* | 27±8* | <0.0001 |
| PCWP (mmHg) | 8±3 | 15±5* | 17±6*† | <0.0001 |
| RAP/PCWP ratio | 0.53±0.20 | 0.56±0.19 | 0.64±0.17*† | 0.0004 |
| LVTMP (mmHg) | 4±2 | 7±4* | 6±4* | <0.0001 |
| LV Stiffness β (/ml) | 5.5±0.2 | 5.7±0.2* | 5.7±0.2* | <0.0001 |
| V30 index (ml/m2) | 85±21 | 75±18* | 73±18* | 0.0003 |
|
| ||||
| Vascular function | ||||
| EaI (mmHg*m2/ml) | 3.2±1.1 | 3.7±1.5 | 3.4±1.1 | 0.2 |
| SVRI (dyne*m2/sec*cm5) | 2918±925 | 3053±1094 | 2789±800 | 0.3 |
| TACI (ml/mmHg*m2) | 0.6±0.3 | 0.5±0.2 | 0.6±0.3 | 0.2 |
| PVRI (dyne*m2/sec*cm5) | 268±116 | 338±168* | 338±173* | 0.007 |
| PACI (ml/mmHg*m2) | 2.2±0.8 | 1.9±0.9 | 2.0±1.1 | 0.1 |
|
| ||||
| Flow measures and Oxygen Consumption | ||||
| Cardiac index (l/min*m2) | 2.7±0.7 | 2.6±0.6 | 2.6±0.6 | 0.7 |
| O2 consumption index (ml/min*kg) | 2.8±0.5 | 2.8±0.6 | 2.2±0.4*† | <0.0001 |
| AV O2 difference (ml/dl) | 4.3±0.8 | 4.6±0.9 | 4.5±0.8 | 0.1 |
|
| ||||
| Exercise | ||||
|
| ||||
| Vital signs | ||||
| Heart rate (bpm) | 106±24 | 99±23 | 97±19* | 0.04 |
| Systolic BP (mmHg) | 173±33 | 174±40 | 191±32*† | 0.006 |
| Mean BP (mmHg) | 110±18 | 114±21 | 120±20* | 0.02 |
|
| ||||
| Central pressures | ||||
| RA pressure (mmHg) | 8±4 | 17±6* | 21±7*† | <0.0001 |
| PASP (mmHg) | 44±13 | 61±16* | 70±15*† | <0.0001 |
| PA mean pressure (mmHg) | 27±8 | 43±10* | 49±10*† | <0.0001 |
| PCWP (mmHg) | 15±5 | 30±5* | 33±7*† | <0.0001 |
| RAP/PCWP ratio | 0.53±0.3 | 0.55±0.2 | 0.64±0.22*† | 0.02 |
| LVTMP (mmHg) | 7±4 | 14±6* | 13±8* | <0.0001 |
|
| ||||
| Vascular function | ||||
| EaI (mmHg*m2/ml) | 3.5±1.4 | 4.2±1.9 | 4.1±1.3 | 0.07 |
| SVRI (dyne*m2/sec*cm5) | 1634±510 | 2070±782* | 1941±498 | 0.01 |
| TACI (ml/mmHg*m2) | 0.6±0.4 | 0.5±0.5 | 0.4±0.3 | 0.2 |
| PVRI (dyne*m2/sec*cm5) | 210±135 | 311±268 | 357±320* | 0.01 |
| PACI (ml/mmHg*m2) | 2.0±1.8 | 1.3±0.8* | 1.1±0.4* | <0.0001 |
|
| ||||
| Flow measures and Oxygen consumption | ||||
| Cardiac index (l/min*m2) | 5.3±1.6 | 4.2±1.3* | 4.3±1.3* | <0.0001 |
| Oxygen consumption (ml/min*kg) | 12.9±4.0 | 10.0±3.4* | 7.7±2.3*† | <0.0001 |
| Arterial-venous O2 difference (ml/dl) | 10.3±2.0 | 10.0±2.1 | 9.6±2.0 | 0.1 |
Data are mean ± SD, median (interquartile range), or n (%). Final column reflects overall group differences.
*
p<0.05 vs controls
†
p<0.05 vs non-obese HFpEF.
BP, blood pressure; Ea, effective arterial elastance; LV, left ventricular; LVTMP, left ventricular transmural pressure; PA, pulmonary artery; PCWP, pulmonary capillary wedge pressure; PVRI, pulmonary vascular resistance index; RA, right atrial; RV, right ventricular; and SVRI, systemic vascular resistance index; V30, left ventricular end-diastolic volume at PCWP 30mmHg.