Right Ventricular Function and Pulmonary Hypertension in HFpEF

Afterload Dependence of Right Ventricular Myocardial Remodeling and Intrinsic Right Ventricular Myocardial Function in Heart Failure With Preserved Ejection Fraction

In patients with heart failure and preserved ejection fraction (HFpEF) right ventricular (RV) systolic and diastolic dysfunction are prognostically and functionally relevant factors but have mechanistically been neglected so far. In the present study alterations of intrinsic RV (systolic and diastolic) function, as assessed by invasive pressure volume loops, are examined in relation to tissue alterations on myocardial level and to the degree of RV afterload (pulmonary hypertension). Study aim is to gain insights into mechanisms contributing to the development of RV dysfunction and potentially identify new therapeutic targets.

HFpEF

Inclusion Criteria:

• Clinical signs of heart failure
• Preserved Left ventricular (LV) Ejection Fraction (EF >= 50%)
• Structural Heart Diseases on echocardiogram/ N terminal-pro-brain natriuretic peptide > 125ng/l
• Elevated LV end-diastolic pressure at rest (>15mmHg) or during exertion (>=25mmHg)

No Heart Failure

Inclusion Criteria:

• No signs of heart failure
• Preserved Left ventricular (LV) Ejection Fraction (EF >= 50%)
• Normal LV end-diastolic pressure at rest (=<15mmHg) and during exertion (<25mmHg)

Exclusion Criteria:

• Significant coronary artery stenosis at time of catheterization
• Acute coronary syndrome or cerebral insult within 1 month of examination
• more than moderate valvular diseases
• pregnancy
• contraindication to cardiac magnetic resonance imaging