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Peak oxygen uptake and self‐reported physical health are strong predictors of long‐term survival after heart transplantation
Author(s) -
Yardley Marianne,
Havik Odd E.,
Grov Ingelin,
Relbo Anne,
Gullestad Lars,
Nytrøen Kari
Publication year - 2016
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12672
Subject(s) - medicine , cohort , proportional hazards model , vo2 max , heart transplantation , cohort study , retrospective cohort study , quality of life (healthcare) , physical fitness , prospective cohort study , transplantation , cardiology , physical therapy , heart rate , blood pressure , nursing
Background Peak oxygen uptake ( VO 2peak ) is known as the gold standard measure of cardiopulmonary fitness. We therefore hypothesized that measures of physical health would predict long‐term survival in heart transplant recipients ( HT x). Methods This retrospective study investigated survival in two HT x populations; the cardiopulmonary exercise test ( CPET ) cohort comprised 178 HT x patients who completed a VO 2peak test during their annual follow‐up (1990–2003), and the SF ‐36 cohort comprised 133 patients who completed a quality of life questionnaire, SF ‐36v1 (1998–2000). Results Mean ( SD ) age in the CPET cohort was 52 (12) yr and 54 (11) yr in the SF ‐36 cohort. Mean observation time was, respectively, 11 and 10 yr. Mean ( SD ) VO 2peak was 19.6 (5.3) mL/kg/min, and median ( IR ) physical function ( PF ) score was 90 (30). VO 2peak and PF scores were both significant predictors in univariate Cox regression. Multiple Cox regression analyses adjusted for other potential predictors showed that VO 2peak , age, and cardiac allograft vasculopathy ( CAV ) were the most important predictors in the CPET cohort, whereas age, PF score, smoking, and CAV were the most important predictors in the SF ‐36 cohort. In Kaplan–Meier analysis, VO 2peak and PF scores above the median value were related to significant longer survival time. Conclusion Peak oxygen uptake and self‐reported physical health are strong predictors for long‐term survival in HT x recipients. VO 2peak is a crucial measurement and should be more frequently used after HT x.