Type 2 diabetes and exercise unexplained dyspnoea: a new focus under the lens with a long way to go yet

Article Cardiac & Cardiovascular Systems

Pulmonary hypertension during exercise underlies unexplained exertional dyspnoea in patients with Type 2 diabetes

Tin Gojevic et al.

Summary: In patients with Type 2 diabetes mellitus, the dyspnoeic group showed abnormal cardiac and pulmonary vascular function during exercise, including lower LV systolic reserve and higher mean pulmonary arterial pressures. These abnormalities may contribute to exertional dyspnoea and reduced exercise capacity in these patients.

EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY (2023)

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Article Cardiac & Cardiovascular Systems

Exercise testing in heart failure with preserved ejection fraction: an appraisal through diagnosis, pathophysiology and therapy - A clinical consensus statement of the Heart Failure Association and European Association of Preventive Cardiology of the European Society of Cardiology

Marco Guazzi et al.

Summary: Patients with heart failure with preserved ejection fraction (HFpEF) commonly experience exercise intolerance and dyspnoea. Various factors contribute to the limited exercise capacity, including impaired cardiac and peripheral vascular function, reduced pulmonary vascular reserve, skeletal muscle dysfunction, and iron deficiency/anaemia. However, the current algorithms/scores for HFpEF diagnosis do not consider the objective measures of exercise performance. This clinical consensus statement aims to highlight the role of exercise testing in HFpEF and its pathophysiological, clinical, and prognostic insights. Additionally, combining echocardiography and/or invasive haemodynamic evaluation with cardiopulmonary exercise testing is essential for assessing, quantifying, and differentiating the origin of dyspnoea and exercise impairment.

EUROPEAN JOURNAL OF HEART FAILURE (2022)

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Article Cardiac & Cardiovascular Systems

Diagnosis of Heart Failure With Preserved Ejection Fraction Among Patients With Unexplained Dyspnea

Yogesh N. Reddy et al.

Summary: This study evaluated the diagnostic performance of H2FPEF and HFA-PEFF scores, as well as the PCWP/CO slope, in diagnosing HFpEF, and found that the H2FPEF score had superior performance compared to the HFA-PEFF score.

JAMA CARDIOLOGY (2022)

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Article Cardiac & Cardiovascular Systems

Metabolic Syndrome Mediates ROS-miR-193b-NFYA-Dependent Downregulation of Soluble Guanylate Cyclase and Contributes to Exercise-Induced Pulmonary Hypertension in Heart Failure With Preserved Ejection Fraction

Taijyu Satoh et al.

Summary: This study elucidated the mechanisms through which metabolic syndrome contributes to pulmonary vascular dysfunction and exercise-induced pulmonary hypertension in patients with heart failure with preserved ejection fraction. Restoring NFYA-sGC beta 1-cGMP signaling can ameliorate EIPH.

CIRCULATION (2021)

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Article Cardiac & Cardiovascular Systems