Heart Failure Hemodynamic Prognostic evaluation and outcome (HF-HOPE)

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Date
2022-08-04
Authors
Pieroni, Olivia
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Abstract

Heart failure (HF) is one of the leading causes of morbidity and mortality worldwide. Although HF is defined as impaired cardiac ability in maintaining physiologically required cardiac output, it is rarely objectively measured. To hemodynamically characterize and identify outcome associated marker in HF patients with preserved ejection fraction (HFpEF), we conducted this study using a whole-body impedance cardiography based Non-Invasive Cardiac System (NICaS). NICaS is fast, non-invasive, cost-effective, validated and approved by the FDA (USA). Forty-two clinically stable HFpEF patients were were evaluated at rest (supine and sitting position), and after exercising on a mounted bike (25 watts, for up to 12 minutes or limited by symptom). Their electronic patient records were reviewed to identify outcome at 6 months (unplanned hospital admission due to HF/arrhythmias, listing for heart transplantation or palliative care, and all-cause death). There was strong relationship between resting and post-exercise hemodynamic parameters, suggesting that resting parameters may be sufficient to characterize these patients. No relationship to age or NYHA class was identified. Twelve participants had high CO (cardiac index >3.8L/min/m2, CO>8L/min). Thirty-three participants had 6-months follow-up; no patient experienced adverse outcomes; 19 had medication changes and 6 were discharged from HF clinic due to clinical improvement. Covid-19 adversely influenced our ability to recruit these patients. Although, we could hemodynamically characterize HFpEF patients, smaller study cohort and shorter follow up were our limitations. Incorporating such measurements in routine clinical care will provide objective measurable parameters, and may provide clinically relevant details.

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Heart failure
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