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: Understanding normal exercise hemodynamics is essential for assessing individuals with exertional dyspnea. This study utilized exercise echocardiography to gain insights into exercise hemodynamics in asymptomatic middle-aged to older adults without overt cardiovascular disease. : We prospectively enrolled 30 individuals aged 45-75 years without dyspnea, excluding those with left ventricular ejection fraction (LVEF) < 50% or significant heart/lung diseases. All participants underwent symptom-limited bicycle exercise echocardiography. : Two individuals exhibited early-stage dyspnea, leading to the inclusion of 28 individuals (mean age 61 ± 8 years, 50% female) in the final analysis. Throughout the exercise, the average E/e' ratio increased from 8.3 ± 1.6 at rest to 9.7 ± 1.8 at 75 W ( = 0.001), while systolic pulmonary artery pressure (SPAP) rose from 23.0 ± 3.9 mmHg at rest to 41.2 ± 9.3 mmHg at 75 W ( < 0.001). Sex-specific analysis revealed a more pronounced elevation in SPAP during exercise among females (SPAP at 75 W, 45.5 ± 8.3 in females; 36.8 ± 8.3 mmHg in males, = 0.011; < 0.001 for interaction between sexes). : In asymptomatic middle-aged to older adults, while there was a slight increase in left ventricular filling pressure and SPAP during exercise, the mean average E/e' and SPAP at peak exercise were below 10 and 50 mmHg, respectively. Our findings also demonstrate sex-specific differences, with females exhibiting a more pronounced elevation in SPAP during exercise.
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http://dx.doi.org/10.3390/diagnostics15111307 | DOI Listing |
J Physiol
September 2025
Institue for Exercise and Environmental Medicine, Texas Presbyterian Hospital, Dallas, TX, USA.
Some patients with heart failure with preserved ejection fraction (HFpEF) have demonstrated evidence of exercise-induced arterial hypoxaemia (EIAH). However, EIAH was not quantified using , , and measurements as previously conducted in healthy adults nor was EIAH quantified alongside simultaneous measurements of pulmonary vascular pressures, cardiorespiratory responses, or dyspnoea on exertion (DOE) in these patients. Given the effects of hypoxaemia on pulmonary vasoconstriction, cardiorespiratory responses, and DOE, we tested the hypothesis that patients with HFpEF and EIAH (EIAH) would demonstrate higher pulmonary vascular pressures, worse oxygen uptake, and greater DOE compared with patients without EIAH (EIAH).
View Article and Find Full Text PDFOpen Heart
September 2025
Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
Background: Balloon pulmonary angioplasty (BPA) improves haemodynamics in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). Previous studies on BPA have set the treatment objective to achieve a mean pulmonary arterial pressure (mPAP) of <30 mm Hg. However, the clinical impact of mPAP after BPA remains unclear.
View Article and Find Full Text PDFCirculation
September 2025
Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA (J.C., C.G., C.N., S.M., I.G., F.M., A.M., C.P., L.R., I.L., N.I., R.M., G.D.L.).
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.
View Article and Find Full Text PDFJ Healthy Eat Act Living
June 2025
Department of Kinesiology, Kansas State University, U.S.A.
Adults with serious mental illness (SMI) die decades early, mostly from heart disease. Few park-based exercise interventions have been tested, none focused on SMI. The study (NCT05293587) tested a 6-week exercise intervention (INT; 45 min park-based exercise led by a certified peer specialist (CPS) 3 days/week) vs.
View Article and Find Full Text PDFCirc Heart Fail
September 2025
Duke University, Durham, NC (F.A., V.K., M.F.).
Background: The atria play an important role in the pathophysiology of heart failure with preserved ejection fraction. Decreased left atrial strain is associated with worse clinical outcomes. The impact of no-implant interatrial shunting on atrial structure and function has not been described.
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