In:
European Journal of Heart Failure, Wiley, Vol. 21, No. 12 ( 2019-12), p. 1586-1595
Abstract:
Exercise oscillatory ventilation (EOV) is a pivotal cardiopulmonary exercise test parameter for the prognostic evaluation of patients with chronic heart failure (HF). It has been described in patients with HF with reduced ejection fraction ( 〈 40%, HFrEF) and with HF with preserved ejection fraction ( 〉 50%, HFpEF), but no data are available for patients with HF with mid‐range ejection fraction (40–49%, HFmrEF).
The aim of the study was to evaluate the prognostic role of EOV in HFmrEF patients. Methods and results We analysed 1239 patients with HFmrEF and 4482 patients with HFrEF, enrolled in the MECKI score database, with a 2‐year follow‐up. The study endpoint was the composite of cardiovascular death, urgent heart transplant, and ventricular assist device implantation. We identified EOV in 968 cases (16% and 17% of cases in HFmrEF and HFrEF, respectively). HFrEF EOV+ patients were significantly older, and their parameters suggested a more severe HF than HFrEF EOV− patients. A similar behaviour was found in HFmrEF EOV+ vs. EOV− patients. Kaplan–Meier analysis, irrespective of ejection fraction, showed that EOV is associated with a worse survival, and that patients with HFrEF and HFmrEF EOV+ had a significantly worse outcome than the EOV− of the same ejection fraction groups. EOV‐associated survival differences in HFmrEF patients started after 18 months of follow‐up. Conclusion Exercise oscillatory ventilation has a similar prevalence and ominous prognostic value in both HFmrEF and HFrEF patients, indicating a group of patients in need of a more intensive follow‐up and a more aggressive therapy. In HFmrEF, the survival curves between EOV+ and EOV− patients diverged only after 18 months.
Type of Medium:
Online Resource
ISSN:
1388-9842
,
1879-0844
Language:
English
Publisher:
Wiley
Publication Date:
2019
detail.hit.zdb_id:
1500332-2
