Characterization and Application of Novel Exercise Recovery Patterns That Reflect Cardiac Performance: A Substudy of the SEQUOIA-HCM Trial.

Background: Post-exercise oxygen uptake recovery (VORec) is slow in advanced heart failure. We sought to establish easily derived VORec measures and evaluate their cardiospecificity and prognostic relevance in patients with dyspnea on exertion. We further sought to determine VORec modifiability proportional to changes in cardiac function with disease-specific treatment of obstructive hypertrophic cardiomyopathy.

Cardiopulmonary Exercise Testing for Characterization of Hypertrophic Cardiomyopathy: A Meta-Analysis.

Background: Hypertrophic cardiomyopathy (HCM) is associated with substantial risk of adverse cardiac events. Consequently, detailed physiologic assessment and accurate risk stratification in HCM are of high clinical importance. This systematic review and meta-analysis synthesizes current evidence on the utility of cardiopulmonary exercise testing (CPET) for characterization and prognostication of HCM.

Effect of COVID-19 Related Social Isolation on Cognitive Decline in Neurocognitive Disorder Patients: A Systematic Review and Meta-Analysis.

The COVID-19 lockdown placed individuals at significant risk of social isolation. Particularly, older people were more vulnerable to the deleterious effects on mental and physical health caused by the COVID-19 pandemic quarantine, in which social confinement was associated with aggravated cognitive function among older adults. Correspondingly, it concerns the repercussions of the lockdown on the cognitive function of patients with dementia or Mild Cognitive Impairment (MCI) during the pandemic.

Physiologic Phenotyping of Responses to Exercise and Activity in Heart Failure.

Subjective and objective limitations to exercise and activity are hallmarks of heart failure (HF), regardless of underlying ejection fraction (EF). These limitations relate to cardiovascular abnormalities involving the systolic and diastolic properties of the heart, venous, and arterial vasculature, as well as noncardiovascular abnormalities, including impairments in pulmonary function, autonomic regulation, anemia, metabolism, and changes in mitochondria and skeletal muscle. The contribution of these abnormalities varies between patients with HF with preserved EF and those with HF with reduced EF, but, even within each HF subtype, there is substantial individual patient pathophysiologic variability, which suggests a potentially important role for phenotyping based on exercise reserve responses to individualize treatment.

Transferrin Saturation Is a Better Predictor Than Ferritin of Metabolic and Hemodynamic Exercise Responses in HFpEF.

Background: Iron is a critical factor in cardiac function, oxygen carrying capacity in the blood, and mitochondrial function in skeletal muscle, all of which are key elements of oxygen uptake and utilization during exercise. However, the impact of iron status on hemodynamic responses to exercise and component variables of peak oxygen consumption in patients with heart failure with preserved ejection fraction (HFpEF) is unknown.

Objectives: The authors sought to determine the relationship between markers of iron status and comprehensive exercise response patterns and clinical outcomes in patients with HFpEF.

Cardiopulmonary Exercise Testing in Advanced Heart Failure Management.

Cardiopulmonary exercise testing (CPET) permits the assessment of gas exchange, electrocardiogram, and hemodynamic patterns throughout exercise, providing a window into multi-organ physiologic reserve during exercise. CPET provides risk stratification and informs management of advanced heart failure (HF). Increasingly, CPET is combined with echocardiography, or invasive right heart catheterization, which enables high-resolution assessment of cardiac and extracardiac limitations to exercise.