Determinants and consequences of heart rate and stroke volume response to exercise in patients with heart failure and preserved ejection fraction

Aims A hallmark of heart failure with preserved ejection fraction (HFpEF) is impaired exercise capacity varying severity. The main determinant cardiac output (CO), however little information available about the relation between constituents CO – rate and stroke volume in HFpEF. We sought to determine if a heterogeneity response exists patients HFpEF describe possible clinical phenotypes associated differences these responses. Methods results Data from two prospective trials (n = 108) study healthy participants 42) invasive haemodynamic measurements during were utilized. Differences central responses analysed regression models. Chronotropic incompetence was present 39–56% 3–56% depending on definition used, but some 47, 44%) had an increase similar that controls. Patients smaller their index (SVI) (HFpEF: +4 ± 10 mL/m2, participants: +24 12 P < 0.0001), indeed, SVI fell 28% at peak exercise. Higher body mass lower rest increases exercise, whereas higher resting rate, angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker use greater Conclusion very heterogeneous among HFpEF, chronotropic observed up 56%, SVI. This suggests testing may be useful identify which benefit interventions targeting response.