| Autor: |
Scheel PJ 3rd; Division of Cardiology Department of Medicine The Johns Hopkins Hospital Baltimore MD., Florido R; Division of Cardiology Department of Medicine The Johns Hopkins Hospital Baltimore MD., Hsu S; Division of Cardiology Department of Medicine The Johns Hopkins Hospital Baltimore MD., Murray B; Division of Cardiology Department of Medicine The Johns Hopkins Hospital Baltimore MD., Tichnell C; Division of Cardiology Department of Medicine The Johns Hopkins Hospital Baltimore MD., James CA; Division of Cardiology Department of Medicine The Johns Hopkins Hospital Baltimore MD., Agafonova J; Division of Cardiology Department of Medicine The Johns Hopkins Hospital Baltimore MD., Tandri H; Division of Cardiology Department of Medicine The Johns Hopkins Hospital Baltimore MD., Judge DP; Division of Cardiology Department of Medicine Medical University of South Carolina Charleston SC., Russell SD; Division of Cardiology Department of Medicine Duke University School of Medicine Durham NC., Tedford RJ; Division of Cardiology Department of Medicine Medical University of South Carolina Charleston SC., Calkins H; Division of Cardiology Department of Medicine The Johns Hopkins Hospital Baltimore MD., Gilotra NA; Division of Cardiology Department of Medicine The Johns Hopkins Hospital Baltimore MD. |
| Jazyk: |
angličtina |
| Zdroj: |
Journal of the American Heart Association [J Am Heart Assoc] 2020 Feb 04; Vol. 9 (3), pp. e013695. Date of Electronic Publication: 2020 Feb 03. |
| DOI: |
10.1161/JAHA.119.013695 |
| Abstrakt: |
Background Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is characterized by high arrhythmic burden and progressive heart failure, which can prompt referral for heart transplantation. Cardiopulmonary exercise testing (CPET) has an established role in risk stratification for advanced heart failure therapies, but has not been described in ARVC/D. This study sought to determine the safety and prognostic utility of CPET in patients with ARVC/D. Methods and Results Using the Johns Hopkins ARVC/D Registry, we examined patients with ARVC/D undergoing CPET. Baseline characteristics and transplant-free survival were compared on the basis of peak oxygen consumption (pVO2) (≤14 or >14 mL/kg per minute) and ventilatory efficiency (Ve/VCO 2 slope ≤34 or >34). Thirty-eight patients underwent 50 CPETs. There were no sustained arrhythmic events. Twenty-nine patients achieved a maximal test. Patients with pVO2 ≤14 mL/kg per minute were more often men ( P =0.042) compared with patients with pVO2 >14 mL/kg per minute. Patients with Ve/VCO 2 slope >34 tended to have more moderate/severe right ventricular dilation (7/9 [78%] versus 10/26 [38%]; P =0.060) and clinical heart failure (8/9 [89%] versus 13/26 [50%]; P =0.056) compared with patients with Ve/VCO 2 slope ≤34. Patients who underwent heart transplantation were more likely to have clinical heart failure (10/10 [100%] versus 13/28 [46%]; P =0.003). Patients with Ve/VCO 2 slope >34 had worse transplant-free survival compared with patients with Ve/VCO 2 slope ≤34 (n=35; hazard ratio, 6.57 [95% CI, 1.28-33.72]; log-rank P =0.010), whereas transplant-free survival was similar on the basis of pVO2 groups (n=29; hazard ratio, 3.38 [95% CI, 0.75-15.19]; log-rank P =0.092). Conclusions CPET is safe to perform in patients with ARVC/D. Ve/VCO 2 slope may be used for risk stratification and guide referral for heart transplantation in ARVC/D. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
|
Plný text