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The pathophysiology of heart failure with preserved ejection fraction

Phan, Thanh Trung (2010)
Ph.D. thesis, University of Birmingham.

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Abstract

Our studies demonstrate that patients with HfpEF have impaired myocardial energetics as indicated by the diminished in vivo myocardial PCr/ATP ratio. Data acquired during semi-supine cycling exercise indicates that patients with HfpEF had a dynamic impairment of LV active relaxation. In addition, ventricular-vascular coupling ratio was unchanged during exercise in HfpEF patients in contrast to healthy controls where the ratio fell substantially during exercise. In addition, we found patients with HfpEF with normal LA dimensions had increased LA contribution during exercise as compared to controls. Furthermore, we showed patients with HfpEF exhibited contractile inefficiency as well as systolic and diastolic dyssynchrony as measured by speckle tracking imaging (STI). And that the LV anterior wall appears to be the most delayed segment. We also demonstrated that HfpEF patients exhibited chronotropic incompetence during peak exercise testing and abnormal HR recovery following exercise compared to age-gender-matched healthy controls and hypertensive patients. In a separate study, we showed that changes in LV torsion, untwist and LV strain and strain rate in patients with HfpEF at rest were similar to changes found in normal aging.

Type of Work:Ph.D. thesis.
Supervisor(s):Frenneaux, Michael
School/Faculty:Colleges (2008 onwards) > College of Medical & Dental Sciences
Department:School of Clinical & Experimental Medicine, Department of Cardiovascular Medicine
Subjects:R Medicine (General)
RC Internal medicine
Institution:University of Birmingham
ID Code:828
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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