Hubungan Rasio E/e' dengan Konsumsi Oksigen Maksimum (VO? Max), Efisiensi Ventilasi (VE/VCO? Slope), dan VO?/HR pada Pasien Gagal Jantung Fraksi Ejeksi Terjaga (HFpEF).

Nisa Munawwarah, Dr. dr. Ratna Dewi Puspita, M.Sc.; dr. Siswanto, Sp.P(K).Onk.

2026 | Tesis | S2 Ilmu Kedokteran Dasar dan Biomedis

Pendahuluan: Gagal jantung dengan fraksi ejeksi terjaga (heart failure with preserved ejection fraction, HFpEF) merupakan salah satu penyakit kardiovaskular yang prevalensinya terus meningkat dan ditandai oleh adanya gejala utama berupa intoleransi saat latihan. Penilaian tekanan pengisian ventrikel kiri melalui rasio E/e’ pada pemeriksaan ekokardiografi seringkali digunakan untuk mengevaluasi fungsi diastolik, tetapi kemampuan dalam merefleksikan kapasitas fungsional selama latihan fisik masih terbatas. Cardiopulmonary exercise testing (CPET) dapat memberikan gambaran integratif terkait respon kardiovaskular, respirasi, dan metabolik selama latihan.

Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara rasio E/e’ dengan konsumsi oksigen maksimum (VO? max), efisiensi ventilasi (VE/VCO? slope), dan oxygen pulse (VO?/HR) pada pasien HFpEF.

Metode: penelitian ini merupakan studi observasional analitik dengan desain cross sectional. Subjek penelitian adalah pasien HFpEF yang menjalani pemeriksaan ekokardiografi dan CPET menggunakan ergocycle dari bulan Maret – Desember 2025. Data rasio E/e’ diperoleh dari rekam medis pemeriksaan ekokardiografi transtorakal, sedangkan data VO? max, VE/VCO? slope, dan VO?/HR diperoleh dari pemeriksaan CPET. Analisis statistik dilakukan untuk menilai hubungan antara rasio E/e’ dan parameter CPET.

Hasil: Hasil penelitian menunjukkan bahwa subjek HFpEF memiliki kapasitas latihan yang rendah dengan variasi nilai VO? max, VE/VCO? slope, dan VO?/HR. Analisis korelasi menunjukkan bahwa rasio E/e’ tidak memiliki hubungan yang bermakna dengan VO? max, VE/VCO? slope, maupun VO?/HR.

Kesimpulan: Rasio E/e’ yang mencerminkan tekanan pengisian ventrikel kiri saat istirahat tidak berkorelasi secara signifikan dengan kapasitas fungsional latihan dan efisiensi ventilasi pada pasien HFpEF. Temuan ini menunjukkan bahwa rasio E/e’ belum sepenuhnya merepresentasikan gangguan fungsional selama aktivitas fisik, sehingga CPET dapat diberikan sebagai pemeriksaan komplementer dalam evaluasi pasien HFpEF.

Introduction: Heart failure with preserved ejection fraction (HFpEF) is a cardiovascular disease with a continuously increasing prevalence and is primarily characterized by exercise intolerance as a hallmark symptom. Assessment of left ventricular filling pressure using the E/e? ratio on echocardiography is frequently employed to evaluate diastolic function; however, its ability to reflect functional capacity during physical exercise remains limited. Cardiopulmonary exercise testing (CPET) provides an integrative assessment of cardiovascular, respiratory, and metabolic responses during exercise. 

Objective: This study aimed to investigate the relationship between the E/e? ratio and maximal oxygen consumption (VO?max), ventilatory efficiency (VE/VCO? slope), and oxygen pulse (VO?/HR) in patients with HFpEF. 

Methods: This study was an analytical observational study with a cross-sectional design. The study subjects were patients with HFpEF who underwent transthoracic echocardiography and cardiopulmonary exercise testing (CPET) using an ergocycle between March and December 2025. The E/e? ratio data were obtained from medical records of transthoracic echocardiographic examinations, while VO?max, VE/VCO? slope, and VO?/HR data were derived from CPET assessments. Statistical analyses were performed to evaluate the relationships between the E/e? ratio and CPET parameters. 

Results: The results demonstrated that patients with HFpEF exhibited reduced exercise capacity, with variability in VO?max, VE/VCO? slope, and VO?/HR values. Correlation analysis revealed that the E/e? ratio was not significantly associated with VO?max, VE/VCO? slope, or VO?/HR.

Conclusion: The E/e? ratio, which reflects left ventricular filling pressure at rest, was not significantly correlated with functional exercise capacity or ventilatory efficiency in patients with HFpEF. These findings suggest that the E/e? ratio does not fully represent functional impairment during physical activity, highlighting the role of CPET as a complementary assessment in the evaluation of patients with HFpEF. 

Kata Kunci : HFpEF, rasio E/e’, VO? max, VE/VCO? slope, VO?/HR