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• W4381621610 abstract "Resting hemodynamics are limited for predicting cardiac function and reserve across many different cardiovascular diseases, especially in early stages. In pulmonary arterial hypertension (PAH), the concept of dynamic exercise testing has offered promise for further risk stratification and discrimination of right heart (RH) performance in the context of impaired pulmonary vascular response mechanisms, however exercise testing standards and thresholds of an abnormal exercise response have not been clearly defined [ [1] Humbert M Kovacs G Hoeper MM Badagliacca R Berger RMF Brida M et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2022; 43: 3618-3731 Crossref PubMed Scopus (273) Google Scholar , [2] Douschan P Avian A Foris V Sassmann T Bachmaier G Rosenstock P et al. Prognostic Value of Exercise as Compared to Resting Pulmonary Hypertension in Patients with Normal or Mildly Elevated Pulmonary Arterial Pressure. Am J Respir Crit Care Med. 2022; 206: 1418-1423 Crossref PubMed Scopus (0) Google Scholar ]. Given the overlapping features of PAH and pulmonary hypertension due to heart failure with preserved ejection fraction (PH-HFpEF), exercise hemodynamic assessment may not only help to discriminate PH type but could also increase deeper phenotypic understanding of adaptive RH performance across these two disease states with different determinants of cardiac output and pulmonary vascular behavior [ [3] Borlaug BA Nishimura RA Sorajja P Lam CS Redfield MM. Exercise hemodynamics enhance diagnosis of early heart failure with preserved ejection fraction. Circ Heart Fail. 2010; 3: 588-595 Crossref PubMed Scopus (781) Google Scholar ]. The use of provocative assessments has an increasing role to play in understanding early RH dysfunction and in stratifying those at greatest risk for PH-associated morbidity and mortality [ [4] Obokata M Reddy YNV Melenovsky V Pislaru S Borlaug BA. Deterioration in right ventricular structure and function over time in patients with heart failure and preserved ejection fraction. Eur Heart J. 2019; 40: 689-697 Crossref PubMed Scopus (154) Google Scholar , [5] van de Veerdonk MC Kind T Marcus JT Mauritz GJ Heymans MW Bogaard HJ et al. Progressive right ventricular dysfunction in patients with pulmonary arterial hypertension responding to therapy. J Am Coll Cardiol. 2011; 58: 2511-2519 Crossref PubMed Scopus (618) Google Scholar ]. Veraprapas Kittipibul Richa Agarwal Right Heart Adaptation to Exercise in Pulmonary Hypertension: An Invasive Hemodynamic StudyJournal of Cardiac FailurePreviewRight heart failure (RHF) represents the final step of distinct diseases, differently involving the pulmonary circulation, such as pulmonary hypertension (PH) owing to heart failure with preserved ejection fraction (HFpEF) and pulmonary arterial hypertension (PAH).1 Irrespective from its etiology, RHF is associated with a dismal prognosis, highlighting the need for an early identification.1,2 In keeping with what was observed in left heart failure,3 RHF may be defined by the inability of the heart to maintain a normal cardiac output (CO) or to do so at the expense of high right atrial pressure (RAP), at rest or during exercise. Full-Text PDF Open Access" @default.
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• W4381621610 date "2023-09-01" @default.
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• W4381621610 title "The Many Sides of Right-Heart Dysfunction: Exploring Exercise Markers in Heart Failure With Preserved Ejection Fraction vs Pulmonary Arterial Hypertension" @default.
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• W4381621610 doi "https://doi.org/10.1016/j.cardfail.2023.06.008" @default.
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