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Noaman S, Kaye D, Nanayakkara S, Dart A, Yong A, Ng M, Vizi D, Duffy S, Cox N, Chan W. Haemodynamic and Metabolic Adaptations in Coronary Microvascular Disease (CMD). Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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2
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Nan Tie E, Vizi D, Nanayakkara S, Kaye D. The Impact of Diabetes on Haemodynamic and Cardiometabolic Responses in Heart Failure With Preserved Ejection Fraction. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Chieng D, Sugumar H, Segan L, Tan C, Vizi D, Al-Kaisey A, Hawson J, Prabhu S, Voskoboinik A, Morton J, Lee G, Mariani J, Le Gerche A, Kistler P, Kalman J, Kaye D, Ling L. Catheter Ablation in Atrial Fibrillation and Heart Failure With Preserved Ejection Fraction Improves Peak Pulmonary Capillary Wedge Pressure, Exercise Capacity and Quality of Life. A Prospective Randomised Controlled Trial (RCT-STALL HFpEF). Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Beale A, O'Donnell J, Nakai M, Nanayakkara S, Vizi D, Carter K, Dean E, Ribiero R, Yiallourou S, Carrington M, Marques F, Kaye D. The Gut Microbiome of Heart Failure With Preserved Ejection Fraction. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Chieng D, Sugumar H, Kaye D, Azzopardi S, Vizi D, Rossi E, Voskoboinik A, Prabhu S, Ling L, Lee G, Kalman J, Kistler P. Prone and Supine 12 Lead Electrocardiography Comparisons: Utility of the Prone ECG for the Detection of Cardiac Conditions in Patients Requiring Prone Ventilation with COVID-19. Heart Lung Circ 2021. [PMCID: PMC8324102 DOI: 10.1016/j.hlc.2021.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Sugumar H, Nanayakkara S, Vizi D, Chieng D, Leet A, Mariani J, Taylor A, Kalman J, Kistler P, Ling L. Impact of catheter ablation on HFpEF in people with comorbid atrial fibrillation and HFpEF using invasive haemodynamic testing. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The impact of catheter ablation (CA) for atrial fibrillation (AF) in patients with heart failure with preserved ejection fraction (HFpEF) is unknown.
Objectives
To determine whether CA for AF reverses adverse haemodynamic changes associated with HFpEF.
Methods
Consecutive consenting patients with EF ≥50% scheduled for index CA underwent baseline exercise right heart catheterisation (exRHC), cardiac output (CO) measurement, cardiac MRI, echocardiogram, QOL questionnaires and BNP testing. HFpEF was defined by resting pulmonary capillary wedge pressure (PCWP) ≥15mmHg or peak exercise PCWP ≥25 mmHg during exRHC. Patients with HFpEF were offered follow-up exRHC ≥6 months post-CA.
Results
Of 252 patients scheduled for CA between April 2017 and Sept 2019, 131 (51.9%) qualified for inclusion, 65 (49.6%) consented to exRHC and 11 (16.9%) were excluded due to a subsequent decrease in EF (10) and uncontrolled hypertension (1). Fifty-four underwent exRHC, with 35 (65%) meeting criteria for HFpEF. Of them 26 (74.3%) who underwent CA, 20 (77%) had a follow up exRHC at 12±6 months follow-up, showing an overall decrease in peak exercise PCWP from 30.3±4.2 to 26.8±4.7 mmHg (p<0.05). Patients without arrhythmia recurrence showed significant improvements in peak exercise PCWP (29.2±3.7 to 22.9±2.0 mmHg (p<0.01). Their cardiac output increased from 10.3±3.0 to 12.1±4.0 mmHg p=0.1), and BNP decreased from (94.6±101.6 to 38.0±34.0 mmHg (p=0.06),whereas those with arrhythmia recurrence did not. Overall, 9 patients (45.0%) no longer met criteria for HFpEF.
Conclusion
There is a high prevalence of HFpEF in people referred for AF ablation. Successful CA for AF reverses the adverse haemodynamic changes associated with HFpEF
Changes in PCWP following AF ablation
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): NHMRC, NHF, RACP
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Affiliation(s)
- H Sugumar
- The Alfred Hospital, Melbourne, Australia
| | | | - D Vizi
- The Alfred Hospital, Melbourne, Australia
| | - D Chieng
- The Alfred Hospital, Melbourne, Australia
| | - A Leet
- The Alfred Hospital, Melbourne, Australia
| | - J Mariani
- The Alfred Hospital, Melbourne, Australia
| | - A Taylor
- The Alfred Hospital, Melbourne, Australia
| | - J Kalman
- The Alfred Hospital, Melbourne, Australia
| | - P Kistler
- The Alfred Hospital, Melbourne, Australia
| | - L Ling
- The Alfred Hospital, Melbourne, Australia
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Beale AL, Cosentino C, Segan L, Mariani J, Vizi D, Evans S, Nanayakkara S, Kaye DM. 130The effect of parity on exercise physiology in women with heart failure with preserved ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Women are overrepresented amongst patients with HFpEF, however the underpinning mechanism for this asymmetric distribution is unclear. Pregnancy has been demonstrated to contribute to cardiovascular risk, and represents a potential gender specific risk factor for HFpEF.
Purpose
To investigate the relationship between parity and severity of HFpEF on invasive haemodynamic and echocardiographic studies.
Methods
Patients referred for investigation of dyspnoea with exercise right heart catheterisation from 2008–19 were included and classified as HFpEF with an ejection fraction (EF) ≥50% and a resting PCWP ≥15mmHg or exercise PCWP ≥25mmHg. All patients underwent detailed haemodynamic and echocardiographic assessment, and an obstetric history including socioeconomic data were obtained using a questionnaire.
Results
58 women were included, and categorised as having either 0–2 births, or ≥3 births, dividing the cohort equally. Women with ≥3 births achieved a lower peak exercise workload than those with 0–2 births (46 [31–68] vs. 38 [24–51] W, p=0.04). Women with ≥3 births had a greater rise in pulmonary capillary wedge pressure indexed to workload with exercise (0.5 [0.3–0.8] vs. 0.3 [0.2–0.5] mmHg/W, p=0.03), paralleled by a greater rise in right atrial pressure (10 [8–12] vs. 7 [3–11] mmHg, p=0.01), pictured. Pulmonary vascular resistance was also higher in women with ≥3 births (1.9 [1.6–2.4] vs. 1.6 [1.4–1.9] mmHg/L/min rest, p=0.046, and 1.9 [2.4–2.4] vs. 1.4 [1–1.8] mmHg/L/min exercise, p=0.024). Left ventricular ejection fraction was lower at rest (60 [57–61] vs. 63 [60–66] %, p=0.008) and during exercise (65 [62–67] vs. 68 [66–70] %, p=0.038) in women with higher parity. Otherwise, echocardiographic parameters did not differ according to parity. There were no significant differences between parity groups in baseline characteristics, including age, body mass index, systemic blood pressure, natriuretic peptides or dyspnea class. Similarly, comorbidities and socioeconomic status did not differ.
Conclusion(s)
Higher parity is associated with impairments in multiple physiologic parameters of HFpEF severity in women, including diastolic reserve, pulmonary vascular resistance, and systolic function. This may indicate a role for pregnancy in the development of HFpEF, and suggests that multiparous women should be targeted for intensification of preventative measures for HFpEF.
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Affiliation(s)
- A L Beale
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | | | - L Segan
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - J Mariani
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - D Vizi
- The Alfred Hospital, Melbourne, Australia
| | - S Evans
- The Alfred Hospital, Melbourne, Australia
| | - S Nanayakkara
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - D M Kaye
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
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Nanayakkara S, Telles F, Beale A, Evans S, Vizi D, Marwick T, Kaye D. Impact of Sub-Clinical Systolic Dysfunction on Exercise Haemodynamics in HFpEF. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Beale A, Cosentino C, Segan L, Mariani J, Vizi D, Evans S, Nanayakkara S, Kaye D. The Effect of Parity on Exercise Physiology in Women with Heart Failure with Preserved Ejection Fraction. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Nanayakkara S, Pemberton C, Patel H, Vizi D, Mak V, Richards AM, Mariani JA, Kaye DM. 1096Mid regional atrial natriuretic peptide is an independent predictor of peak pulmonary capillary wedge pressure in patients with heart failure with preserved ejection fraction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Nanayakkara
- The Alfred Hospital, Department of Cardiovascular Medicine, Melbourne, Australia
| | - C Pemberton
- University of Otago Christchurch, Christchurch Heart Institute, Christchurch, New Zealand
| | - H Patel
- The Alfred Hospital, Department of Cardiovascular Medicine, Melbourne, Australia
| | - D Vizi
- The Alfred Hospital, Department of Cardiovascular Medicine, Melbourne, Australia
| | - V Mak
- The Alfred Hospital, Department of Cardiovascular Medicine, Melbourne, Australia
| | - A M Richards
- University of Otago Christchurch, Christchurch Heart Institute, Christchurch, New Zealand
| | - J A Mariani
- The Alfred Hospital, Department of Cardiovascular Medicine, Melbourne, Australia
| | - D M Kaye
- The Alfred Hospital, Department of Cardiovascular Medicine, Melbourne, Australia
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Telles F, Nanayakkara S, Evans S, Vizi D, William J, Marwick T, Kaye D. P5655Influence of left atrial strain and stiffness on haemodynamics in heart failure with preserved ejection fraction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- F Telles
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - S Nanayakkara
- The Alfred Hospital, Department of Cardiovascular Medicine, Melbourne, Australia
| | - S Evans
- The Alfred Hospital, Department of Cardiovascular Medicine, Melbourne, Australia
| | - D Vizi
- The Alfred Hospital, Department of Cardiovascular Medicine, Melbourne, Australia
| | - J William
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - T Marwick
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - D Kaye
- The Alfred Hospital, Department of Cardiovascular Medicine, Melbourne, Australia
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Nanayakkara S, Telles F, Evans S, Vizi D, William, Kaye D. Association of Rest and Exercise Left Ventricular Strain with Exercise Haemodynamics in Patients with Heart Failure with Preserved Ejection Fraction. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Telles F, Nanayakkara S, Evans S, Vizi D, William J, Marwick T, Kaye D. Impaired Left Atrial Strain Predicts Abnormal Haemodynamics in Heart Failure with Preserved Ejection Fraction. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Nanayakkara S, Haykowsky M, Mariani J, Van Empel V, Maeder M, Vizi D, Kaye D. Age-Specific Haemodynamic Features in HFpEF: Implications for Therapy. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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