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Oxygen Uptake Efficiency Plateau during Cardiopulmonary Exercise Testing Is Best Predictor of Early Death in Heart Failure Patients
Author(s) -
Sun Xingguo,
Hansen James E
Publication year - 2010
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.24.1_supplement.615.5
Subject(s) - medicine , cardiology , oxygen pulse , anaerobic exercise , heart failure , stroke volume , ejection fraction , vo2 max , respiratory minute volume , cardiac output , qrs complex , cardiopulmonary exercise test , heart rate , blood pressure , physical therapy , respiratory system
Our goal was to identify better predictors of early death in patients with chronic left ventricular heart failure (CHF). Potential predictors, derived from cardiopulmonary exercise tests (CPX), were compared with other commonly used cardiovascular measurements. The prediction of early death in CHF patients remains challenging. METHODS & RESULTS 508 patients with CHF due to systolic dysfunction had resting cardiovascular measurements, six‐minute walking tests and CPX. The peak O2 uptake (VO2), peak O2 pulse, anaerobic threshold (AT), ratio of ventilation to CO2 output (VE/VCO2), VE‐vs‐VCO2 slope, and oxygen uptake efficiency plateau (OUEP, i.e. Highest VO2/VE) were ascertained. Outcomes were six‐month mortality (all cause death). During six‐month follow‐up, 19 patients died and 489 patients survived. The single best predictor of early mortality was the decreased OUEP (<65%pred)(OR=12.8). The lowest VE/VCO2, VE‐vs‐VCO2 slope, peak VO2, AT and peak O2 pulse alone were strong predictors, their best OR values were 9.4, 7.6, 6.0, 5.1 and 4.3 respectively (p<0.001). No non‐exercise measurements (i.e. NYHA, QRS duration, ejection fraction, blood pressure, cardiac output and stroke volume) discriminated mortality. CONCLUSIONS CPX parameters are powerful prognosticators of early mortality in CHF patients, especially the reduced OUEP.