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http://hdl.handle.net/1942/36019
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DC Field | Value | Language |
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dc.contributor.author | MARTENS, Pieter | - |
dc.contributor.author | Claessen , G | - |
dc.contributor.author | van de Bruaene, A | - |
dc.contributor.author | VERBRUGGE, Frederik | - |
dc.contributor.author | HERBOTS, Lieven | - |
dc.contributor.author | DENDALE, Paul | - |
dc.contributor.author | VERWERFT, Jan | - |
dc.date.accessioned | 2021-12-02T14:55:31Z | - |
dc.date.available | 2021-12-02T14:55:31Z | - |
dc.date.issued | 2021 | - |
dc.date.submitted | 2021-09-13T14:14:18Z | - |
dc.identifier.citation | Journal of cardiac failure, 27 (7) , p. 766 -776 | - |
dc.identifier.uri | http://hdl.handle.net/1942/36019 | - |
dc.description.abstract | Background: Iron deficiency (ID) is frequent and associated with diminished exercise capacity in heart failure (HF), but its contribution to unexplained dyspnea without a HF diagnosis at rest remains unclear.Methods and Results: Consecutive patients with unexplained dyspnea and normal echocardiography and pulmonary function tests at rest underwent prospective standardized cardiopulmonary exercise testing with echocardiography in a tertiary care dyspnea clinic. ID was defined as ferritin of <300 mg/L and a transferrin saturation of <20% and its impact on peak oxygen uptake (peakVO(2)), biventricular response to exercise, and peripheral oxygen extraction was assessed. Of 272 patients who underwent cardiopulmonary exercise testing with echocardiography, 63 (23%) had ID. For a similar respiratory exchange ratio, patients with ID had lower peakVO(2) (14.6 +/- 7.6 mL/kg/minvs 17.8 +/- 8.8 mL/kg/min; P=.009) and maximal workload (89 +/- 50 watt vs 108 +/- 56 watt P=.047), even after adjustment for the presence of anemia. At rest, patients with ID had a similar left ventricular and right ventricular (RV) contractile function. During exercise, patients with ID had lower cardiac output reserve (P <.05) and depressed RV function by tricuspid s' (P=.004), tricuspid annular plane systolic excursion (P=.034), and RV end-systolic pressure-area ratio (P=.038), with more RV-pulmonary artery uncoupling measured by tricuspid annular plane systolic excursion/systolic pulmonary arterial pressure ratio (P=.023). RV end-systolic pressure-area ratio change from rest to peak exercise, as a load-insensitive metric of RV contractility, was lower in patients with ID (2.09 +/- 0.72 mm Hg/cm(2) vs 2.58 +/- 1.14 mm Hg/cm(2); P <.001). ID was associated with impaired peripheral oxygen extraction (peakVO(2)/peak cardiac output; P=.036). Cardiopulmonary exercise testing with echocardiography resulted in a diagnosis of HF with preserved ejection fraction in 71 patients (26%) based on an exercise E/e' ratio of >14, with equal distribution in patients with (28.6%) or without ID (25.4%, P=.611). None of these findings were influenced in a sensitivity analysis adjusted for a final diagnosis of HFpEF as etiology for the unexplained dyspnea.Conclusions: In patients with unexplained dyspnea without clear HF at rest, ID is common and associated with decreased exercise capacity, diminished biventricular contractile reserve, and decreased peripheral oxygen extraction. | - |
dc.description.sponsorship | Pieter Martens has received a research grant from Viforpharma and Fonds Wetenschappelijk Onderzoek (grantnumber: 1127917N) and consultancy fees from AstraZe-neca, Abbott, Bayer, Boehringer-Ingelheim, Novartis, andVifor pharma. Frederik Verbrugge is supported by a Felowship of the Belgian American Educational Foundation(B.A.E.F.) and by the Special Research Fund (BOF) of Has-selt University (BOF19PD04). | - |
dc.language.iso | en | - |
dc.publisher | CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS | - |
dc.rights | 2021 Elsevier Inc. All rights reserved. | - |
dc.subject.other | Dyspnea | - |
dc.subject.other | iron deficiency | - |
dc.subject.other | cardiopulmonary exercise testing | - |
dc.subject.other | pathophysiology | - |
dc.subject.other | contractile reserve | - |
dc.title | Iron Deficiency Is Associated With Impaired Biventricular Reserve and Reduced Exercise Capacity in Patients With Unexplained Dyspnea | - |
dc.type | Journal Contribution | - |
dc.identifier.epage | 776 | - |
dc.identifier.issue | 7 | - |
dc.identifier.spage | 766 | - |
dc.identifier.volume | 27 | - |
local.bibliographicCitation.jcat | A1 | - |
local.publisher.place | CURTIS CENTER, INDEPENDENCE SQUARE WEST, PHILADELPHIA, PA 19106-3399 USA | - |
local.type.refereed | Refereed | - |
local.type.specified | Article | - |
dc.identifier.doi | 10.1016/j.cardfail.2021.03.010 | - |
dc.identifier.isi | 000670534500006 | - |
local.provider.type | Web of Science | - |
local.uhasselt.international | no | - |
item.validation | ecoom 2022 | - |
item.contributor | MARTENS, Pieter | - |
item.contributor | Claessen , G | - |
item.contributor | van de Bruaene, A | - |
item.contributor | VERBRUGGE, Frederik | - |
item.contributor | HERBOTS, Lieven | - |
item.contributor | DENDALE, Paul | - |
item.contributor | VERWERFT, Jan | - |
item.accessRights | Restricted Access | - |
item.fullcitation | MARTENS, Pieter; Claessen , G; van de Bruaene, A; VERBRUGGE, Frederik; HERBOTS, Lieven; DENDALE, Paul & VERWERFT, Jan (2021) Iron Deficiency Is Associated With Impaired Biventricular Reserve and Reduced Exercise Capacity in Patients With Unexplained Dyspnea. In: Journal of cardiac failure, 27 (7) , p. 766 -776. | - |
item.fulltext | With Fulltext | - |
crisitem.journal.issn | 1071-9164 | - |
crisitem.journal.eissn | 1532-8414 | - |
Appears in Collections: | Research publications |
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File | Description | Size | Format | |
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Iron Deficiency Is Associated With Impaired Biventricular Reserve and Reduced Exercise Capacity in Patients With Unexplained Dyspnea.pdf Restricted Access | Published version | 1.45 MB | Adobe PDF | View/Open Request a copy |
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