1. Optimizing exercise testing‐based risk stratification to predict poor prognosis after acute heart failure
- Author
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Shyh‐Ming Chen, Po‐Jui Wu, Lin‐Yi Wang, Chin‐Ling Wei, Cheng‐I Cheng, Hsiu‐Yu Fang, Yen‐Nan Fang, Yung‐Lung Chen, David Kwan‐Ru Huang, Fan‐Yen Lee, and Mien‐Cheng Chen
- Subjects
Advanced heart failure ,Cardiac transplantation ,Peak VO2 ,Guideline‐directed medical therapy ,Risk score ,HFSS ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Aims The timely selection of severe heart failure (HF) patients for cardiac transplantation and advanced HF therapy is challenging. Peak oxygen consumption (VO2) values obtained by the cardiopulmonary exercise testing are used to determine the transplant recipient list. This study reassessed the prognostic predictability of peak VO2 and compared it with the Heart Failure Survival Score (HFSS) in the modern optimized guideline‐directed medical therapy (GDMT) era. Methods and results We retrospectively selected 377 acute HF patients discharged from the hospital. The primary outcome was a composite of all‐cause mortality, or urgent cardiac transplantation. We divided these patients into the more GDMT (two or more types of GDMT) and less GDMT groups (fewer than two types of GDMT) and compared the performance of their peak VO2 and HFSS in predicting primary outcomes. The median follow‐up period was 3.3 years. The primary outcome occurred in 57 participants. Peak VO2 outperformed HFSS when predicting 1 year (0.81 vs. 0.61; P = 0.017) and 2 year (0.78 vs. 0.58; P
- Published
- 2023
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