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2. Atrial Fibrillation Ablation for Heart Failure With Preserved Ejection Fraction: A Randomized Controlled Trial

Author

Chieng, David, Sugumar, Hariharan, Segan, Louise, Tan, Caleb, Vizi, Donna, Nanayakkara, Shane, Al-Kaisey, Ahmed, Hawson, Joshua, Prabhu, Sandeep, Voskoboinik, Aleksandr, Finch, Sue, Morton, Joseph B., Lee, Geoffrey, Mariani, Justin, La Gerche, Andre, Taylor, Andrew J., Howden, Erin, Kistler, Peter M., Kalman, Jonathan M., Kaye, David M., and Ling, Liang-Han

Published
2023
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4. Hyperlactataemia is a marker of reduced exercise capacity in heart failure with preserved ejection fraction.

Author

Nan Tie, Emilia, Wolsk, Emil, Nanayakkara, Shane, Vizi, Donna, Mariani, Justin, Moller, Jacob Eifer, Hassager, Christian, Gustafsson, Finn, and Kaye, David M.

Subjects
BLOOD lactate, AEROBIC capacity, CHRONIC kidney failure, HEART failure, CARDIAC catheterization
Abstract

Aims: Heart failure with preserved ejection fraction (HFpEF) is associated with an array of central and peripheral haemodynamic and metabolic changes. The exact pathogenesis of exercise limitation in HFpEF remains uncertain. Our aim was to compare lactate accumulation and central haemodynamic responses to exercise in patients with HFpEF, non‐cardiac dyspnoea (NCD), and healthy volunteers. Methods and results: Right heart catheterization with mixed venous blood gas and lactate measurements was performed at rest and during symptom‐limited supine exercise. Multivariable analyses were conducted to determine the relationship between haemodynamic and biochemical parameters and their association with exercise capacity. Of 362 subjects, 198 (55%) had HFpEF, 103 (28%) had NCD, and 61 (17%) were healthy volunteers. This included 139 (70%) females with HFpEF, 77 (75%) in NCD (P = 0.41 HFpEF vs. NCD), and 31 (51%) in healthy volunteers (P < 0.001 HFpEF vs. volunteers). The median age was 71 (65, 75) years in HFpEF, 66 (57, 72) years in NCD, and 49 (38, 65) years in healthy volunteers (HFpEF vs. NCD or volunteer, both P < 0.001). Peak workload was lower in HFpEF compared with healthy volunteers [52 W (interquartile range 31–73), 150 W (125–175), P < 0.001], but not NCD [53 W (33, 75), P = 0.85]. Exercise lactate indexed to workload was higher in HFpEF at 0.08 mmol/L/W (0.05–0.11), 0.06 mmol/L/W (0.05–0.08; P = 0.016) in NCD, and 0.04 mmol/L/W (0.03–0.05; P < 0.001) in volunteers. Exercise cardiac index was 4.5 L/min/m2 (3.7–5.5) in HFpEF, 5.2 L/min/m2 (4.3–6.2; P < 0.001) in NCD, and 9.1 L/min/m2 (8.0–9.9; P < 0.001) in volunteers. Oxygen delivery in HFpEF was lower at 1553 mL/min (1175–1986) vs. 1758 mL/min (1361–2282; P = 0.024) in NCD and 3117 mL/min (2667–3502; P < 0.001) in the volunteer group during exercise. Predictors of higher exercise lactate levels in HFpEF following adjustment included female sex and chronic kidney disease (both P < 0.001). Conclusions: HFpEF is associated with reduced exercise capacity secondary to both central and peripheral factors that alter oxygen utilization. This results in hyperlactataemia. In HFpEF, plasma lactate responses to exercise may be a marker of haemodynamic and cardiometabolic derangements and represent an important target for future potential therapies. [ABSTRACT FROM AUTHOR]

Published
2024
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11. B-PO03-174 PRONE & SUPINE 12 LEAD ELECTROCARDIOGRAPHY COMPARISONS: UTILITY OF THE PRONE EKG FOR THE DETECTION OF CARDIAC CONDITIONS IN PATIENTS REQUIRING PRONE VENTILATION WITH COVID-19

Author

Chieng, David, primary, Sugumar, Hariharan, additional, Kaye, David, additional, Azzopardi, Sonia, additional, Vizi, Donna, additional, Rossi, Erina, additional, Voskoboinik, Aleksandr, additional, Prabhu, Sandeep, additional, Ling, Liang-Han, additional, Lee, Geoffrey, additional, Kalman, Jonathan M., additional, and Kistler, Peter M., additional

Published
2021
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12. The Gut Microbiome of Heart Failure With Preserved Ejection Fraction

Author

Beale, Anna L., primary, O’Donnell, Joanne A., additional, Nakai, Michael E., additional, Nanayakkara, Shane, additional, Vizi, Donna, additional, Carter, Kaye, additional, Dean, Eliza, additional, Ribeiro, Rosilene V., additional, Yiallourou, Stephanie, additional, Carrington, Melinda J., additional, Marques, Francine Z., additional, and Kaye, David M., additional

Published
2021
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13. THE MICROBIOME OF HEART FAILURE WITH PRESERVED EJECTION FRACTION

Author

Beale, Anna, primary, O’Donnell, Joanne A., additional, Nakai, Michael E., additional, Nanayakkara, Shane, additional, Vizi, Donna, additional, Carter, Kaye, additional, Dean, Eliza, additional, Ribiero, Rosilene, additional, Yiallourou, Stephanie, additional, Carrington, Melissa, additional, Marques, Francine, additional, and Kaye, David M., additional

Published
2021
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14. A prospective STudy using invAsive haemodynamic measurements foLLowing catheter ablation for AF and early HFpEF : STALL AF‐HFpEF

Author

Sugumar, Hariharan, primary, Nanayakkara, Shane, additional, Vizi, Donna, additional, Wright, Leah, additional, Chieng, David, additional, Leet, Angeline, additional, Mariani, Justin A., additional, Voskoboinik, Aleksandr, additional, Prabhu, Sandeep, additional, Taylor, Andrew J., additional, Kalman, Jonathan M., additional, Kistler, Peter M., additional, Kaye, David M., additional, and Ling, Liang‐Han, additional

Published
2021
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17. Alcohol Abstinence in Drinkers with Atrial Fibrillation

Author

Voskoboinik, Aleksandr, primary, Kalman, Jonathan M., additional, De Silva, Anurika, additional, Nicholls, Thomas, additional, Costello, Benedict, additional, Nanayakkara, Shane, additional, Prabhu, Sandeep, additional, Stub, Dion, additional, Azzopardi, Sonia, additional, Vizi, Donna, additional, Wong, Geoffrey, additional, Nalliah, Chrishan, additional, Sugumar, Hariharan, additional, Wong, Michael, additional, Kotschet, Emily, additional, Kaye, David, additional, Taylor, Andrew J., additional, and Kistler, Peter M., additional

Published
2020
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