title: High prevalence of exercise-induced heart failure with normal ejection fraction in post-heart transplant patients.
abstract: OBJECTIVE
  Post-heart transplant patients are at increased risk of diastolic dysfunction. The aim of this study was to assess the prevalence of isolated only exercise-induced heart failure with normal ejection fraction (HFNEF) in heart transplant recipients.
  
  
  RESULTS
  To determine pulmonary capillary wedge pressure (PCWP) at rest and during exercise, 81 patients after orthotopic heart transplantation with normal left ventricular ejection fraction (LVEF) underwent exercise right heart catheterization with simultaneous exercise echocardiography. Based on PCWP values, the patients were divided into three groups. Twenty-one patients had no evidence of HFNEF (PCWP at rest < 15 mmHg, maximal PCWP during exercise < 25 mmHg, prevalence 26%). Forty-seven subjects were found to have only exercise-induced HFNEF (PCWP at rest < 15 mmHg, maximal PCWP during exercise ≥ 25 mmHg, prevalence 58%). Thirteen patients had HFNEF already at rest (PCWP ≥ 15 mmHg at rest, prevalence 16%). Of the noninvasive parameters obtained at rest, multivariate regression analysis identified LV mass index adjusted for allograft age to be an independent predictor of exercise-induced HFNEF.
  
  
  CONCLUSIONS
  In heart transplant recipients with normal LVEF, there is a high prevalence of exercise-induced HFNEF. LV mass index adjusted for allograft age is predictive of exercise-induced HFNEF.
authors: Department of Cardiovascular Diseases, ICRC, St. Anne's Hospital in Brno, Czech Republic.
authors: Jaroslav
authors: J
authors: Meluzin
authors: Petr
authors: P
authors: Hude
authors: Pavel
authors: P
authors: Leinveber
authors: Jan
authors: J
authors: Krejci
authors: Lenka
authors: L
authors: Spinarova
authors: Helena
authors: H
authors: Bedanova
authors: Helena
authors: H
authors: Podrouzkova
authors: Radka
authors: R
authors: Stepanova
authors: Petr
authors: P
authors: Nemec
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization; D004452:Echocardiography; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000209:etiology* / Q000503:physiopathology; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011669:Pulmonary Wedge Pressure; D012146:Rest / Q000502:physiology; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000473:pathology* / Q000503:physiopathology*