{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:05:06Z","timestamp":1792512306959,"version":"4.5.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2021,6,17]],"date-time":"2021-06-17T00:00:00Z","timestamp":1623888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Heart Fail"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Circulating blood volume is functionally divided between the unstressed volume, which fills the vascular space, and stressed blood volume (SBV), which generates vascular wall tension and intravascular pressure. With decreases in venous capacitance, blood functionally shifts to the SBV, increasing central venous pressure and pulmonary venous pressures. Obesity is associated with both elevated venous pressure and heart failure with preserved ejection fraction (HFpEF). To explore the mechanisms underlying this association, we evaluated relationships between blood volume distribution, venous compliance, and body mass in patients with and without HFpEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\n                      Subjects with HFpEF (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u200962) and non\u2010cardiac dyspnoea (NCD) (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u200979) underwent invasive haemodynamic exercise testing with echocardiography. SBV was estimated (eSBV) from measured haemodynamic variables fit to a comprehensive cardiovascular model. Compared to NCD, patients with HFpEF displayed a leftward\u2010shifted central venous pressure\u2013dimension relationship, indicating reduced venous compliance. eSBV was 81% higher at rest and 69% higher during exercise in HFpEF than NCD (both\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u20090.0001), indicating reduced venous capacitance. Despite greater augmented eSBV with exercise, the increase in cardiac output was reduced in HFpEF, suggesting operation on the plateau of the Starling curve. Exercise eSBV was directly correlated with higher body mass index (r\u00a0=\u00a00.77,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u20090.0001) and inversely correlated with right ventricular\u2013pulmonary arterial coupling (r\u00a0=\u00a0\u22120.57, all\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with HFpEF display reductions in systemic venous compliance and increased eSBV related to reduced venous capacitance, abnormalities in right ventricular\u2013pulmonary artery interaction, and increased body fat. These data provide new evidence supporting an important role of venous dysfunction in obesity\u2010related HFpEF and suggest that therapies that improve venous function may hold promise to improve clinical status in this cohort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2254","type":"journal-article","created":{"date-parts":[[2021,5,30]],"date-time":"2021-05-30T09:10:40Z","timestamp":1622365840000},"page":"1648-1658","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":122,"title":["Obesity, venous capacitance, and venous compliance in heart failure with preserved ejection fraction"],"prefix":"10.1093","volume":"23","author":[{"given":"Hidemi","family":"Sorimachi","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic  Rochester MN 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