Exercise ventilation inefficiency and dynamic tricuspid regurgitation in heart failure

Abstract Background Exercise ventilation inefficiency, i.e. increase slope of the relationship (VE) vs carbon dioxide (VCO2) is a key prognostic indicator in heart failure (HF). Many determinants have been identified primarily related to left and impaired reflexogenic control VE. In parallel, severity tricuspid regurgitation (TR) at rest increasingly recognized as an important determinant functional status prognosis. It undefined whether VE inefficiency may be dynamic TR during exercise. Purpose We tested role its correlates exercise by combining cardiopulmonary test (CPET) with echocardiography. Methods prospectively studied stable HF patients both reduced preserved ventricular ejection fraction (LVEF). Patients severe pulmonary disease those who underwent valve replacement or cardiac surgery were excluded. Mitral degree adjudicated accordingly ESC Guidelines criteria. Demographics clinical characteristics along laboratory parameters including electrolytes, biomarkers congestion (NT-proBNP), renal liver function, collected time CPET. Dynamic was defined worsening grade from stress detected Doppler analysis. VE/VCO2 peak oxygen consumption (pVO2) compared between (Group 1) non-dynamic 2). Results Among 56 (66±13 years, 64% men, mean LVEF 50±14%, 35% ischemic) 12% showed least moderate mitral 16% had rest. jet velocity associated (r=0.36 r=0.3 respectively, p value <0.05, Figure 1). A pattern appeared 28 (50%) patients. No differences characteristics, parameters, LV fraction, prevalence found two groups. Group 1 2 exhibited lower right fractional area change (45% [41–50] 52% [44–62] p=0.03), median pVO2 (13.3 [10.4–17.5] 16.3 [13.9–21.8], respectively (p=0.04)) higher (40.3 [33.1–44] 34.1 [29.2–38.8], p=0.01; 2A B). Conclusions CPET imaging exhibit worse efficiency that extent. These data prospect, for first time, interaction ventilatory whose relevance translate targeting appropriately. Funding Acknowledgement Type funding sources: None.