Central and peripheral effects of acute and long-term exercise in patients with heart failure

Patients with heart failure can be symptomless at rest but experience symptoms during physical exercise. Medical examinations performed at exercise can unmask symptoms and reveal a lack of reserve capacity. Cardiac magnetic resonance imaging (CMR), the gold standard method for quantifying left ventricular volumes and function, has traditionally been performed at rest due to technical limitations. While cardiac imaging studies using for example echocardiography has previously been used to investigate the heart during physical exercise, there is still a gap in knowledge about cardiac pumping physiology and hemodynamics during exercise in both normal hearts and failing hearts.

Recent advances in CMR imaging now enables us to perform exercise CMR, acquiring images during physical exercise. Further, development in post-processing technology allows us to derive additional hemodynamic parameters from CMR. These include non-invasive pressure-volume (PV) loops derived from CMR and brachial pressure measurements, and hydraulic force, a novel mechanism of diastolic function.

The overall aim of this project is to utilize these modern CMR techniques to increase our understanding of hemodynamic mechanisms underlying heart failure, and how these are affected by physical exercise.