This video presentation introduces a pragmatic three-step hemodynamic assessment protocol designed to identify the heart failure with preserved ejection fraction (HFpEF) phenotype. Combining volume challenge and upper arm exercise, this protocol aims to overcome complexities and extended cath lab times associated with traditional exercise-invasive hemodynamics.
The study included patients with undetermined dyspnea, NYHA class II and III, and intermediate HFpEF likelihood. The three assessments conducted (HR, BP and SPO₂) were baseline, post-volume load, and during upper arm exercise, using pulmonary capillary wedge pressure thresholds to diagnose HFpEF.
Results demonstrated that most symptomatic patients showed significant hemodynamic changes, particularly increased filling pressures and blunted cardiac output response—hallmarks of HFpEF. This protocol appears fast, straightforward, and widely implementable, offering a potentially valuable tool to unmask HFpEF in its earliest stage in routine clinical settings.
This case report and/or content does not reflect the opinion of iHF or iheartfunction.com, nor does it engage their responsibility.
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