Right ventricle dysfunction and pulmonary hypertension are related to a worse prognosis in
patients with heart failure with reduced left ventricular ejection fraction (HFrEF) or with
normal left ventricular ejection fraction (HFpEF).
There is preliminary evidence however, that the responses of the right ventricle and of the
pulmonary hemodynamics to stress tests (especially physical stress) may allow to
prognostically stratify these patients, as these responses may bring out latent right
ventricle dysfunction or a normal contractile reserve in patients with dysfunction at rest.
In view of the different pathophysiological mechanisms of the left ventricular dysfunction in
HFpEF and in HFrEF, also the response and the adaptation of the righty ventricle to stress
tests may be different in these two groups of patients.
In this preliminary two groups of 20 patients with HFpEF and HFrEF will be subjected to to
simple stress tests: passive leg raising and inotropic stimulus with dobutamine.
This study intends to analyze, through colorDoppler echocardiography, the behaviour of the
right ventricle and the pulmonary circulation during passive leg raining and infusion of
dobutamine, in a cohort of patients with HFrEF or HFpEF.
The analysis will be focused on the relation between echocardiographic parameters, especially
those concerning right ventricular function and pulmonary hemodynamics, thereby comparing the
responses observed in HFrEF vs HFpEF.
Furthermore, correlations between the above-mentioned echocardiographic parameters and
parameters of daily clinical practice will be assessed.