Abnormalities in cardiopulmonary exercise test associated with more advance atrial cardiomyopathy

J. Dziano, J. Howie, J. Ariyaratnam, M. Middeldorp, M. Emami, R. Mishima, P. Sanders, A. Elliott

Research output: Contribution to journalConference articlepeer-review

Abstract

Background Cardiopulmonary Exercise Testing (CPET) provides prognostic and diagnostic value in patients with heart failure. However, the use of CPET to evaluate the extent of atrial cardiomyopathy in symptomatic AF patients has not been examined. Objective Evaluate the association between the number of pulmonary gas exchange abnormalities during CPET and measures of LA function amongst patients with symptomatic AF. Methods Patients with symptomatic paroxysmal or persistent AF, undergoing ablation were assessed. Participants completed maximal CPET on a cycle ergometer. Oxygen consumption (VO2peak), ventilatory efficiency (VE/VCO2 slope) and partial pressure of end-tidal CO2 (PETCO2) were stratified according to international criteria and patients trichotomized according to number of CPET abnormalities (0, 1 or ≥2). LA strain and LA minimum volume were assessed by resting echocardiography. LA pressure was measured invasively during ablation and monitored during continuous saline infusion into the LA (15mL/kg over 8 minutes). LA diameter was assessed by transoesophageal echocardiography throughout the saline infusion. LA Compliance was calculated as ΔLA Diameter/ΔPeak LA Pressure. Results 125 participants were recruited (mean age 63±11, 72% male). Patients with more CPET abnormalities had higher LA minimum volume at rest (p=0.025), lower LA reservoir strain (p=0.001) and higher NT-proBNP (p=0.058). In those with more CPET abnormalities, LA compliance was lower (p=0.009) and LA pressure at rest was similar (p=0.14), but significantly higher during fluid loading (p=0.05). Conclusion Abnormalities detected in CPET may provide a useful non-invasive tool to identify patients with more advanced atrial cardiomyopathy in patients with symptomatic AF.

Original languageEnglish
Pages (from-to)S146-S147
JournalHeart Lung and Circulation
Volume33
DOIs
Publication statusPublished or Issued - Aug 2024
Externally publishedYes
Event72nd Annual Scientific Meeting of the Cardiac Society of Australia and New Zealand - Perth, Australia
Duration: 1 Aug 20244 Aug 2024

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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