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The prognostic utility of cardiopulmonary exercise testing stands the test of time in patients with heart failure.
- Source :
-
Journal of cardiopulmonary rehabilitation and prevention [J Cardiopulm Rehabil Prev] 2012 Jul-Aug; Vol. 32 (4), pp. 198-202. - Publication Year :
- 2012
-
Abstract
- Introduction: While the medical management strategy for patients with heart failure (HF) has dramatically changed, cardiopulmonary exercise testing (CPX) procedures and the data obtained have remained relatively stable. We are unaware of any previous investigation that has assessed differences in the prognostic utility of CPX in HF according to time period, reflecting differences in the clinical management of systolic HF.<br />Methods: Subjects (n = 381) underwent CPX between April 1, 1993, and December 31, 2005, and the remaining 511 were tested between January 1, 2006, and October 28, 2010. Peak oxygen uptake ((Equation is included in full-text article.)O2) and the minute ventilation/carbon dioxide production ((Equation is included in full-text article.)E/(Equation is included in full-text article.)CO2) slope were ascertained for all tests.<br />Results: Both the (Equation is included in full-text article.)E/(Equation is included in full-text article.)CO2 slope and peak (Equation is included in full-text article.)O2 were strong univariate predictors of adverse events in both subgroups. In the multivariate analysis, the (Equation is included in full-text article.)E/(Equation is included in full-text article.)CO2 slope was the strongest predictive marker while peak (Equation is included in full-text article.)O2 added predictive value and was retained in the regression for all scenarios. In subjects undergoing CPX before 2006, a (Equation is included in full-text article.)E/(Equation is included in full-text article.)CO2 slope 45 or greater and a peak (Equation is included in full-text article.)O2 of less than 10 mL · kg · min generated a hazard ratio of 4.2 (95% CI: 1.9-9.1, P < .001) when considering only mortality as an endpoint. In subjects undergoing CPX after 2006, a (Equation is included in full-text article.)E/(Equation is included in full-text article.)CO2 slope 45 or greater and a peak (Equation is included in full-text article.)O2 of less than 10 mL · kg · min generated a hazard ratio of 8.2 (95% CI: 4.7-14.3, P < .001) when considering only mortality as an endpoint.<br />Conclusion: The results of this study indicate that CPX continues to be a valuable clinical assessment in the present-day HF management.
- Subjects :
- Chi-Square Distribution
Confidence Intervals
Exercise Tolerance
Female
Heart Failure drug therapy
Heart Failure pathology
Heart Failure psychology
Humans
Linear Models
Male
Middle Aged
Multivariate Analysis
Oxygen Consumption physiology
Prognosis
Time
Exercise Test instrumentation
Heart Failure rehabilitation
Subjects
Details
- Language :
- English
- ISSN :
- 1932-751X
- Volume :
- 32
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of cardiopulmonary rehabilitation and prevention
- Publication Type :
- Academic Journal
- Accession number :
- 22760244
- Full Text :
- https://doi.org/10.1097/HCR.0b013e318259f153