Abstract
[Background] Heart failure with preserved ejection fraction (HFPEF) causes pulmonary
hypertension (PH) in association with left ventricular diastolic dysfunction. Recent studies
suggested that exercise-induced PH precedes the development of HEFPEF. Hypertension is one of
the major risk factors for HFPEF. There are few studies regarding the impact of exercise on
pulmonary artery pressure (PAP) in hypertensive patients.
[Aim] The present study investigated the impact of exercise on pulmonary hemodynamics in
hypertensive patients.
[Methods and Results] We used exercise stress echocardiography to study 41 consecutive
asymptomatic patients with essential hypertension and 30 healthy volunteers as controls.
Resting PAP was similar between hypertensive patients and controls and was normal in both
groups. PAP at peak exercise was significantly increased compared with resting PAP in both
groups and was significantly higher in hypertensive patients compared with controls. None in
either group had exercise-induced PH. PAP at peak exercise was significantly correlated with left
ventricular diastolic dysfunction in hypertensive patients.
[Conclusions] The present study suggests that an exercise-induced increase in PAP is
exaggerated in its association with left ventricular diastolic dysfunction in asymptomatic patients
with hypertension. Such an exaggerated response to exercise may be related to the future
development of exercise-induced PH, and furthermore to HEFPEF. Further investigation is
needed.
