Changes in cardiopulmonary reserve and peripheral arterial function concomitantly with subclinical inflammation and oxidative stress in patients with heart failure with preserved ejection fraction.
Background. Changes in cardiopulmonary reserve and biomarkers related to wall stress, inflammation, and oxidative stress concomitantly with the evaluation of peripheral arterial blood flow have not been investigated in patients with heart failure with preserved ejection fraction (HFpEF) compared with healthy subjects (CTL). Methods and Results. Eighteen HFpEF patients and 14 CTL were recruited. Plasma levels of inflammatory and oxidative stress biomarkers were measured at rest. Brain natriuretic peptide (BNP) was measured at rest and peak exercise. Cardiopulmonary reserve was assessed using an exercise protocol with gas exchange analyses. Peripheral arterial blood flow was determined by strain gauge plethysmography. Peak VO2 (12.0 ± 0.4 versus 19.1 ± 1.1 mL/min/kg, P < 0.001) and oxygen uptake efficiency slope (1.55 ± 0.12 versus 2.06 ± 0.14, P < 0.05) were significantly decreased in HFpEF patients compared with CTL. BNP at rest and following stress, C-reactive-protein, interleukin-6, and TBARS were significantly elevated in HFpEF. Both basal and posthyperemic arterial blood flow were not significantly different between the HFpEF patients and CTL. Conclusions. HFpEF exhibits a severe reduction in cardiopulmonary reserve and oxygen uptake efficiency concomitantly with an elevation in a broad spectrum of biomarkers confirming an inflammatory and prooxidative status in patients with HFpEF.
Research Center, Montreal Heart Institute, Université de Montréal, 5000 Belanger Street East, Montreal, QC, Canada H1T 1C8 ; Departments of Medicine and Pharmacology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
Damien
D
Vitiello
Research Center, Montreal Heart Institute, Université de Montréal, 5000 Belanger Street East, Montreal, QC, Canada H1T 1C8 ; Departments of Medicine and Pharmacology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
François
F
Harel
Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK ; The Kidney Research Center, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
Rhian M
RM
Touyz
Research Center, Montreal Heart Institute, Université de Montréal, 5000 Belanger Street East, Montreal, QC, Canada H1T 1C8 ; Departments of Medicine and Pharmacology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
Martin G
MG
Sirois
Research Center, Montreal Heart Institute, Université de Montréal, 5000 Belanger Street East, Montreal, QC, Canada H1T 1C8.
Joel
J
Lavoie
Palo Alto VA Health Care System, Stanford University, Palo Alto, CA, USA.
Jonathan
J
Myers
Research Center, Montreal Heart Institute, Université de Montréal, 5000 Belanger Street East, Montreal, QC, Canada H1T 1C8.
Anique
A
Ducharme
Research Center, Montreal Heart Institute, Université de Montréal, 5000 Belanger Street East, Montreal, QC, Canada H1T 1C8.
Normand
N
Racine
Research Center, Montreal Heart Institute, Université de Montréal, 5000 Belanger Street East, Montreal, QC, Canada H1T 1C8.
Eileen
E
O'Meara
Research Center, Montreal Heart Institute, Université de Montréal, 5000 Belanger Street East, Montreal, QC, Canada H1T 1C8 ; Departments of Medicine and Pharmacology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada ; Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montreal, QC, Canada.
Mathieu
M
Gayda
Coordinating Center, Montreal Heart Institute, Montreal, QC, Canada.
Malorie
0000-0001-9798-6096
M
Chabot-Blanchet
Research Center, Montreal Heart Institute, Université de Montréal, 5000 Belanger Street East, Montreal, QC, Canada H1T 1C8.
Jean Lucien
JL
Rouleau
Research Center, Montreal Heart Institute, Université de Montréal, 5000 Belanger Street East, Montreal, QC, Canada H1T 1C8 ; Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada.
Simon
S
de Denus
Research Center, Montreal Heart Institute, Université de Montréal, 5000 Belanger Street East, Montreal, QC, Canada H1T 1C8 ; Departments of Medicine and Pharmacology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
Michel
0000-0002-7945-1343
M
White