Prognostic Value of Cardiopulmonary Exercise Test in Elderly Women with Heart Failure and Reduced or Preserved Ejection Fraction

Autor:	Alessandro Ferraironi, Renata De Maria, Marina Parolini, Marco Renzi, Angela Beatrice Scardovi, Franco Turi, Tiziana Di Giacomo, Roberto Ricci
Rok vydání:	2014
Předmět:	medicine.medical_specialty Mitral regurgitation Ejection fraction business.industry Atrial fibrillation medicine.disease Nyha class Interquartile range Internal medicine Cardiopulmonary exercise test Heart failure Cardiology Breathing Medicine business
Zdroj:	World Journal of Cardiovascular Diseases. :341-349
ISSN:	2164-5337 2164-5329
DOI:	10.4236/wjcd.2014.47043
Popis:	The prognostic role of cardiopulmonary exercise test (CPET) in elderly women with chronic heart failure (HF) has not yet been clarified. We assessed the incremental value of CPET variables for risk stratification in female HF patients with preserved or reduced left ventricular ejection fraction (LVEF). We prospectively followed up 131 female HF outpatients aged 72 [interquartile range 62 - 77] years after a symptom limited CPET. 34% had ischemic heart disease and 14% permanent atrial fibrillation, 24% were in NYHA class III. LVEF was 50% [interquartile range 36 - 62], peak oxygen consumption was 11.3 [interquartile range 9.2 - 13.5] ml/kg/min; the slope of the regression line relating ventilation to CO2 output was 33.9 [interquartile range 30.3 - 44.9]; 40% of patients showed exercise oscillatory breathing during CPET. During a median follow-up of 18 months [interquartile range 8 - 54], overall 39 patients (29.7%) met the combined end-point of cardiovascular mortality or HF admission using a time-to-first event approach. Moderate to severe mitral regurgitation, slope, exercise oscillatory breathing were independently associated to cardiovascular mortality or HF admission. When CPET ventilatory variables were added to clinical and echocardiographic parameters, prediction of the combined point improved significantly (AUC 0.755 (95% CI 0.662 to 0.832) vs 0.634 (95% CI 0.536 to 0.725), p = 0.016). In conclusion, among elderly female HF patients the CPET derived parameters EOB and VE/VCO2 slope emerged as strong prognostic markers, with additive predictive value to clinical and echocardiographic parameters in patients with both reduced and preserved LVEF.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::d3060d0337fde9969b1e512d5ae6a548 https://doi.org/10.4236/wjcd.2014.47043 Zobrazit plný text záznamu