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Paulus, Walter J., MD, PhD; van Heerebeek, Loek, MD, PhD
Journal of the American College of Cardiology, 10/2015, Letnik: 66, Številka: 15Journal Article
First among the proposed mechanisms for exercise intolerance in HFpEF is high LV diastolic stiffness (5), which elicits a prompt and large increase in PCWP (7), even at low-level exercise, as illustrated in the study by Borlaug et al. At the very low cGMP levels observed in HFpEF myocardium, the cardiomyocytes could well be operating on the ascending limb of the dose-response curve with a concomitant LV systolic shortening deficit and the large increase in LVSW during exercise after nitrite infusion could be consistent with increased myocardial cGMP eliciting a move up the ascending limb.
