Right Ventricular Function and Pulmonary Hypertension in HFpEF

Heart Center Leipzig - University Hospital45 enrolled

Overview

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.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Heart Failure With Preserved Ejection Fraction

Interventions

Invasive hemodynamics and myocardial biopsiesDIAGNOSTIC_TEST

Invasive hemodynamic characterization (biventricular pressure volume loop assessment) and biventricular myocardial biopsies

Medical Language ↔ Plain English

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

Outcomes

Primary Outcomes

Right ventricular systolic and diastolic function

Assessed with pressure volume loops analysis

Time frame: Baseline

Biventricular myocardial fibrosis

Assessed with histopathology

Time frame: Baseline

Phosphorylation of structural myocardial proteins

Assessed on myocardial biopsy specimen

Time frame: Baseline

Secondary Outcomes

Functional capacity

6-Minute Walk Test / Spiroergometry

Time frame: Baseline

Myocardial fibrosis on cardiac magnetic resonance

Time frame: Baseline

Right Ventricular Function and Pulmonary Hypertension in HFpEF

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes