Julio Núñez, Doctor

CONTACT

Vicente Bertomeu, Doctor

CONTACT

Lead Sponsor

Fundación para la Investigación del Hospital Clínico de Valencia

Age

18 - No limit years

Sex

ALL

Healthy Volunteers

No

•Stable symptomatic heart failure (NYHA functional class ≥II) during the last month.
•Diagnosis criteria of HFpEF according to ESC guidelines:
•1. symptoms and signs of HF.
•2. left ventricular ejection fraction ≥50% by Simpson method.
•3. proBNP \>125 pg/mL in the last month.
•4. at least one additional criterion: 1. relevant structural heart disease (left ventricular hypertrophy and/or left atrial enlargement); and/or 2. Diastolic dysfunction.
•Left ventricular hypertrophy was defined as wall thickness \> 10 mm.
•Small ventricular volume was defined as indexed left ventricular end diastolic volume \< 45 ml/m2.
•Adults ≥18 years old.
•Previous admission for acute heart failure.
•Chronotropic incompetence assessed by CPET, defined as: \[(HRmax - HRrest)\]/\[(220 - age) - (HRrest)\] \< 0.62.
•Resting heart rate \< 65 bpm in sinus rhythm or 70 bmp in atrial fibrillation.

•Inability to perform a valid baseline exercise test.
•Significant primary pulmonary disease; including pulmonary arterial hypertension, chronic thromboembolic pulmonary disease or chronic obstructive pulmonary disease.
•Patient with prior history of left ventricular ejection fraction \<50%.
•History of an acute coronary syndrome in the previous 12 months.
•Effort angina or signs of ischemia during CPET.
•RER threshold at \<1.05 at the CPET.
•Significant primary moderate to severe valvular disease.
•Any other comorbidity with a life expectancy lower than 1 year.
•Heart rate at rest \> 75 lpm.
•Other pacemaker indication.
•Pregnant women.
•Baseline rhythm different from sinus rhythm or atrial fibrillation.
•Active treatment with beta-blockers, digitalis or non dihidropiridine calcium channel blockers.