Causes of exercise intolerance in heart failure with preserved ejection fraction: searching for consensus

Nicholas E Houstis; Gregory D Lewis

doi:10.1016/j.cardfail.2014.07.010

Causes of exercise intolerance in heart failure with preserved ejection fraction: searching for consensus

J Card Fail. 2014 Oct;20(10):762-778. doi: 10.1016/j.cardfail.2014.07.010. Epub 2014 Aug 7.

Authors

Nicholas E Houstis¹, Gregory D Lewis²

Affiliations

¹ Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
² Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: glewis@partners.org.

PMID: 25108084
DOI: 10.1016/j.cardfail.2014.07.010

Abstract

Exercise intolerance is one of the cardinal symptoms of heart failure with preserved ejection fraction (HFpEF). We review its mechanistic basis using evidence from exercise studies. One barrier to a consensus understanding of the pathophysiology is heterogeneity of the patient population. Therefore, we pay special attention to varying study definitions of the disease and their possible impact on the causal factors that are implicated. We then discuss the role of exercise testing and its potential to subtype HFpEF in to more homogeneous mechanism-based subclasses.

Keywords: Exercise testing; Fick; VO(2)max; diagnostic criteria.

Publication types

Review

MeSH terms

Exercise Test
Exercise Tolerance*
Heart Failure* / diagnosis
Heart Failure* / physiopathology
Humans
Reference Values
Stroke Volume*