VE/VCO2 Predicts RV Dysfunction and Mortality after Left Ventricular Assist Device: A Fresh Look at Cardiopulmonary Stress Testing for Prognostication
| Autor: | Selma F. Mohammed, Farooq H. Sheikh, Ezequiel J. Molina, A. Kadakkal, Ish Talati, Sara Kalantari, Maria E. Rodrigo, Christopher Barnett, Mark Hofmeyer, Jonathan Grinstein, Yazan Sawalha, Raja Zaghlol, Samer S. Najjar |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Pulmonary and Respiratory Medicine Transplantation medicine.medical_specialty 030109 nutrition & dietetics business.industry medicine.medical_treatment Stress testing Hemodynamics Cardiopulmonary exercise testing 030204 cardiovascular system & hematology medicine.disease 03 medical and health sciences 0302 clinical medicine Internal medicine Ventricular assist device Heart failure medicine Cardiology Surgery Single institution Cardiology and Cardiovascular Medicine Peak vo2 business |
| Zdroj: | The Journal of Heart and Lung Transplantation. 38:S106-S107 |
| ISSN: | 1053-2498 |
| Popis: | Purpose Cardiopulmonary exercise testing (CPET) is well validated for prognostication before advanced surgical heart failure therapies but its role in prognostication after LVAD surgery has never been studies. Methods All CPET studies from a single institution were collected between September 2007 and March 2018. Patients who ultimately underwent LVAD implantation were selectively analyzed. Peak VO2, and VE/VCO2 slope were measured for all patients. We evaluated their association with hemodynamic and clinical markers of RV dysfunction as well mortality. Results 449 patients underwent CPET testing. 120 patients were ultimately referred to the advanced heart failure program and 61 patients later received LVAD implantation (18 axial flow, 43 centrifugal flow, 70% male). CPET testing occurred 554 ± 624 days before LVAD and RHC occurred 232 ± 243 days after LVAD. Patients with a ventilatory class of III or greater (VE/VCO2 slope of ≥ 36, n = 38) had greater rates of death (21% vs. 0%, p = 0.02) than patients with VE/VCO2 slope Conclusion Elevated preoperative VE/VCO2 slope is a predictor of post-operative mortality and is associated with post-operative hemodynamic markers of impaired RV performance. |
| Databáze: | OpenAIRE |
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