Exercise oscillatory ventilation and prognosis in heart failure patients with reduced and mid-range ejection fraction.

Autor: Rovai S; U.O Scompenso, Centro Cardiologico Monzino, IRCCS, Milan, Italy.; Sport and Exercise Medicine Division, Department of Medicine, Università degli Studi di Padova, Padova, Italy., Corrà U; Cardiology Department, Istituti Clinici Scientifici Maugeri, IRCCS, Veruno Institute, Veruno, Italy., Piepoli M; UOC Cardiologia, G da Saliceto Hospital, Piacenza, Italy., Vignati C; U.O Scompenso, Centro Cardiologico Monzino, IRCCS, Milan, Italy.; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milano, Milan, Italy., Salvioni E; U.O Scompenso, Centro Cardiologico Monzino, IRCCS, Milan, Italy., Bonomi A; U.O Scompenso, Centro Cardiologico Monzino, IRCCS, Milan, Italy., Mattavelli I; U.O Scompenso, Centro Cardiologico Monzino, IRCCS, Milan, Italy., Arcari L; Cardiology Division, Santo Spirito Hospital, Rome, Italy., Scardovi AB; Cardiology Division, Santo Spirito Hospital, Rome, Italy., Perrone Filardi P; Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy., Lagioia R; Division of Cardiology, 'S. Maugeri' Foundation, IRCCS, Institute of Cassano Murge, Bari, Italy., Paolillo S; Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy., Magrì D; Department of Clinical and Molecular Medicine, Azienda Ospedaliera Sant'Andrea, 'Sapienza' Università degli Studi di Roma, Rome, Italy., Limongelli G; Cardiologia SUN, Ospedale Monaldi (Azienda dei Colli), Seconda Università di Napoli, Naples, Italy., Metra M; Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Senni M; Department of Cardiology, Heart Failure and Heart Transplant Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy., Scrutinio D; UOC Cardiologia, G da Saliceto Hospital, Piacenza, Italy., Raimondo R; Divisione di Cardiologia Riabilitativa, Fondazione Salvatore Maugeri, IRCCS, Istituto Scientifico di Tradate, Italy., Emdin M; UOC Cardiologia e Medicina cardiovascolare, Fondazione Gabriele Monasterio, CNR-Regione Toscana, Pisa, Italy.; Life Science Institute, Life Science Institute, Scuola Superiore Sant'Anna, Pisa, Italy., Lombardi C; Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy., Cattadori G; Unità Operativa Cardiologia Riabilitativa, Multimedica IRCCS, Milan, Italy., Parati G; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.; Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Istituto Auxologico Italiano, Milan, Italy., Re F; Cardiology Division, Cardiac Arrhythmia Center and Cardiomyopathies Unit, San Camillo-Forlanini Hospital, Rome, Italy., Cicoira M; Section of Cardiology, Department of Medicine, University of Verona, Verona, Italy., Villani GQ; UOC Cardiologia, G da Saliceto Hospital, Piacenza, Italy., Minà C; Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS - ISMETT, Palermo, Italy., Correale M; Department of Cardiology, University of Foggia, Foggia, Italy., Frigerio M; Dipartimento Cardiologico 'A. De Gasperis', Ospedale Cà Granda-A.O. Niguarda, Milan, Italy., Perna E; Dipartimento Cardiologico 'A. De Gasperis', Ospedale Cà Granda-A.O. Niguarda, Milan, Italy., Mapelli M; U.O Scompenso, Centro Cardiologico Monzino, IRCCS, Milan, Italy., Magini A; U.O Scompenso, Centro Cardiologico Monzino, IRCCS, Milan, Italy., Clemenza F; Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS - ISMETT, Palermo, Italy., Bussotti M; Cardiac Rehabilitation Unit, Fondazione Salvatore Maugeri, IRCCS, Scientific Institute of Milan, Milan, Italy., Battaia E; Department of Cardiology, S. Chiara Hospital, Trento, Italy., Guazzi M; Cardiology University Department, Heart Failure Unit and Cardiopulmonary Laboratory, IRCCS Policlinico San Donato, San Donato Milano, Italy., Bandera F; Cardiology University Department, Heart Failure Unit and Cardiopulmonary Laboratory, IRCCS Policlinico San Donato, San Donato Milano, Italy., Badagliacca R; Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, 'Sapienza', Rome University, Rome, Italy., Di Lenarda A; Department of Cardiology, Cardiovascular Center, Health Authority no. 1 and University of, Trieste, Italy., Pacileo G; Cardiologia SUN, Ospedale Monaldi (Azienda dei Colli), Seconda Università di Napoli, Naples, Italy., Maggioni A; ANMCO Research Center, Florence, Italy., Passino C; UOC Cardiologia e Medicina cardiovascolare, Fondazione Gabriele Monasterio, CNR-Regione Toscana, Pisa, Italy.; Life Science Institute, Life Science Institute, Scuola Superiore Sant'Anna, Pisa, Italy., Sciomer S; Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, 'Sapienza', Rome University, Rome, Italy., Sinagra G; Cardiovascular Department, Ospedali Riuniti and University of Trieste, Trieste, Italy., Agostoni P; U.O Scompenso, Centro Cardiologico Monzino, IRCCS, Milan, Italy.; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milano, Milan, Italy.
Jazyk: angličtina
Zdroj: European journal of heart failure [Eur J Heart Fail] 2019 Dec; Vol. 21 (12), pp. 1586-1595. Date of Electronic Publication: 2019 Nov 28.
DOI: 10.1002/ejhf.1595
Abstrakt: Aims: Exercise oscillatory ventilation (EOV) is a pivotal cardiopulmonary exercise test parameter for the prognostic evaluation of patients with chronic heart failure (HF). It has been described in patients with HF with reduced ejection fraction (<40%, HFrEF) and with HF with preserved ejection fraction (>50%, HFpEF), but no data are available for patients with HF with mid-range ejection fraction (40-49%, HFmrEF). The aim of the study was to evaluate the prognostic role of EOV in HFmrEF patients.
Methods and Results: We analysed 1239 patients with HFmrEF and 4482 patients with HFrEF, enrolled in the MECKI score database, with a 2-year follow-up. The study endpoint was the composite of cardiovascular death, urgent heart transplant, and ventricular assist device implantation. We identified EOV in 968 cases (16% and 17% of cases in HFmrEF and HFrEF, respectively). HFrEF EOV+ patients were significantly older, and their parameters suggested a more severe HF than HFrEF EOV- patients. A similar behaviour was found in HFmrEF EOV+ vs. EOV- patients. Kaplan-Meier analysis, irrespective of ejection fraction, showed that EOV is associated with a worse survival, and that patients with HFrEF and HFmrEF EOV+ had a significantly worse outcome than the EOV- of the same ejection fraction groups. EOV-associated survival differences in HFmrEF patients started after 18 months of follow-up.
Conclusion: Exercise oscillatory ventilation has a similar prevalence and ominous prognostic value in both HFmrEF and HFrEF patients, indicating a group of patients in need of a more intensive follow-up and a more aggressive therapy. In HFmrEF, the survival curves between EOV+ and EOV- patients diverged only after 18 months.
(© 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiology.)
Databáze: MEDLINE
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