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  • Patients of HFpEF and...

Patients of HFpEF and anaemia may have exercise intolerance and lower exercise capacity

Written By : Aditi |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2024-01-20T02:15:58+05:30  |  Updated On 20 Jan 2024 11:10 AM IST
Patients of HFpEF and anaemia may have exercise intolerance and lower exercise capacity
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Heart failure with preserved ejection fraction (HFpEF) is becoming more common. This condition is primarily manifested as exercise intolerance. Multiple factors contribute to reduced exercise capacity in HFpEF, including anemia, which is common in these patients and associated with poor outcomes. Various factors can cause anaemia in HFpEF, but the link between anaemia and exercise intolerance in this condition is poorly understood.

According to a study published in the International Journal of Cardiology Heart & Vasculature, HFpEF patients with anaemia showed signs of greater LV remodelling, plasma volume expansion, limitations in arterial O2 delivery and peripheral O2 extraction, and ventilatory inefficiency, leading to reduced exercise capacity. Further research is necessary to devise an effective treatment strategy for anaemic HFpEF patients.

Two hundred thirty-eight patients with HFpEF and 248 dyspneic patients without HF underwent ergometry exercise stress echocardiography with simultaneous expired gas analysis. HFpEF patients were classified into two groups based on anaemia (haemoglobin < 13.0 g/dL for men and < 12.0 g/dL for women.

There needs to be the availability of more data on how anaemia contributes to reduced exercise capacity in HFpEF. This background was further investigated in this study.

Key findings from this study are:

  • Compared to those without anaemia, 112 Anemic HFpEF patients had worse nutritional status and renal function, lower iron levels, and greater left ventricular (LV) remodelling and plasma volume expansion than those without anaemia.
  • In the anaemic HFpEF group, there was lower exercise capacity, assessed by peak oxygen consumption, exercise intensity, and exercise duration, compared to the other groups.
  • Anaemic patients with HFpEF had limitations in arterial O2 delivery, lower arteriovenous O2 content difference, and ventilatory inefficiency during peak exercise.

They said, “The results of our study encourage the screening assessment of anaemia in patients with HFpEF. This can provide insights into the causes of exercise intolerance.”

Study limitations are selection and referral bias, and the sample size was small. Patients with HFpEF were carefully identified, but some may have been missed. Control participants had shortness of breath, poor exercise capacity, and multiple comorbidities, including interstitial lung disease, they mentioned.

Reference:

Naito A et al. Contributions of anemia to exercise intolerance in heart failure with preserved ejection fraction-An exercise stress echocardiographic study. Int J Cardiol Heart Vasc. 2023 Aug 20;48:101255. doi: 10.1016/j.ijcha.2023.101255




Heart failure with preserved ejection fractionanemiaExercise Intolerance in HFpEF PatientsExercise Intolerance
Source : International Journal of Cardiology Heart & Vasculature,
Aditi
Aditi

    BDS, MDS in Periodontics and Implantology

    Dr. Aditi Yadav is a BDS, MDS in Periodontics and Implantology. She has a clinical experience of 5 years as a laser dental surgeon. She also has a Diploma in clinical research and pharmacovigilance and is a Certified data scientist. She is currently working as a content developer in e-health services. Dr. Yadav has a keen interest in Medical Journalism and is actively involved in Medical Research writing.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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