In:
Journal of Cardiopulmonary Rehabilitation and Prevention, Ovid Technologies (Wolters Kluwer Health), Vol. 42, No. 1 ( 2022-01), p. 39-44
Abstract:
Cardiopulmonary exercise testing (CPX) is a well-established assessment with important insight into prognosis and therapeutic efficacy in patients with heart failure (HF). Prior studies have identified several clinical differences between Black or African American (B-AA) and Caucasian patients with HF. Differences in key CPX responses between these two groups require further investigation. Methods: Using a database consisting of subjects with symptomatic HF who had undergone CPX for inclusion in various prospective randomized clinical trials, we identified 198 (n = 94 [47%] B-AA; n = 105 [53%] Caucasian) patients with a qualifying baseline CPX. Significant univariate predictors of peak oxygen uptake (V˙ o 2peak ) were included in a multivariate linear regression model. Results: When compared with Caucasian patients, B-AA were younger (mean ± SD = 54.8 ± 10.0 vs 57.9 ± 9.6 yr, P = .03), had higher C-reactive protein (CRP) (median [IQR] = 4.9 [2.3, 8.8] vs 1.9 [0.6, 5.5] mg/L, P 〈 .0001), lower hemoglobin (13.0 ± 1.8 vs 13.8 ± 1.6 g/dL, P = .003), and lower left ventricular ejection fraction (LVEF) (40 [32, 51] vs 53 [43, 59] %, P 〈 .00010). During CPX, B-AA patients also had lower V˙ o 2peak (14.6 ± 3.9 vs 17.6 ± 4.8 mL·kg −1 ·min −1 , P 〈 .0001). No differences were observed between B-AA and Caucasian in the minute ventilation/carbon dioxide production (V˙ e /V˙ co 2 ) slope ( P = .14). The difference in V˙ o 2peak between B-AA and Caucasian was largely attenuated after adjusting for age, body mass index, CRP, N-terminal pro-brain natriuretic peptide, hemoglobin, LVEF, and peak HR (14.1: 95% CI, 13.2-14.9 vs 15.6: 95% CI, 14.4-16.8 mL·kg −1 ·min −1 , P = .053). Conclusions: Directly measured V˙ o 2peak was significantly lower in B-AA than in Caucasians with HF. This is largely explained by differences in clinical characteristics, whereas no significant differences were observed in the V˙ e /V˙ co 2 slope.
Type of Medium:
Online Resource
ISSN:
1932-7501
DOI:
10.1097/HCR.0000000000000605
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2022
detail.hit.zdb_id:
2271356-6
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