In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 130, No. suppl_2 ( 2014-11-25)
Abstract:
Many studies have reported the prognostic significance of peak oxygen consumption (VO 2 ) and V E -VCO 2 slope in patients with heart failure (HF). However, there are limited data stratifying risk based on a combination of these measures and how to best use them. Purpose: Describe 1 and 3-y event rates for the composite endpoint of mortality, left ventricular assist device (LVAD), or cardiac transplant (CT) based on the combined evaluation of peak VO 2 and V E -VCO 2 slope in patients with HF with reduced ejection fraction (≤ 40%; HFrEF). Methods: Patients (n= 1,116; 33% female; age= 54 ± 13 y) with a cardiopulmonary exercise test between 1997 and 2010 and confirmed HFrEF were identified. Endpoint data was obtained through 2011. Patients were grouped based on peak VO 2 ( 〈 12, 12 to18, and 〉 18 mL/kg/min) and (V E -VCO 2 slope ≥ 34 or 〈 34). Cumulative events were identified from life tables. Cox regression with adjustment for age, gender, ejection fraction, and beta-blocker therapy was used to calculate the hazard ratio for V E -VCO 2 slope ≥ 34 within each peak VO 2 group. Results: The 1 and 3-y event rates are shown in the Table. Among patients with a peak VO 2 〈 12, 1 and 3-y events were 23% and 44%, respectively. Within this group, V E -VCO 2 slope ≥ 34 represented more than twice the risk at both 1 y (HR 2.42, 95% CI 1.09, 5.38) and 3 y (HR 2.32, 95% CI 1.33, 4.05). Among patients with a peak VO 2 12 to 18, 1 and 3-y events were 14% and 30%, respectively. Within this group, a V E -VCO 2 slope ≥ 34 was associated with increased risk at both 1 y (HR 1.80, 95% CI 1.13, 2.87) and 3 y (HR 1.80, 95% CI 1.30, 2.50). Among patients with peak VO 2 〉 18, 1 and 3-y events were 2% and 10%, respectively, and V E -VCO 2 slope was not statistically associated with increased risk. Conclusion: Among patients with a peak VO 2 ≤ 18, V E -VCO 2 slope ≥ 34 further refines the risk for a composite endpoint of mortality, LVAD, or CT at both 1 and 3 y.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.130.suppl_2.14036
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2014
detail.hit.zdb_id:
1466401-X
detail.hit.zdb_id:
80099-5
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