| Defining the optimal prognostic window for cardiopulmonary exercise testing in patients with heart failure. | |
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MedLine Citation:
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PMID: 20200329 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Ventilatory efficiency (VE/VCO(2) slope) and peak oxygen consumption (VO) provide robust prognostic information in patients with heart failure undergoing cardiopulmonary exercise testing (CPX). The purpose of this study is to assess the change in prognostic characteristics of CPX at different time intervals. METHODS AND RESULTS: Seven hundred ninety-one subjects (74% male, mean age: 60.7+/-12.9 years, ejection fraction: 34.6+/-15.0%, ischemic etiology: 51%) underwent CPX and were tracked for major cardiac events over a 4-year period. All event-free subjects were tracked for at least 3 years. Mean VE/VCO(2) slope and peak VO(2) were 35.0+/-10.0 and 16.0+/-6.4 mL O(2) . kg(-1) . min(-1), respectively. There were a total of 263 major cardiac events (199 deaths, 45 transplants, and 19 left ventricular assist device implantations). Both continuous and dichotomous expressions of the VE/VCO(2) slope and peak VO(2) were prognostically significant up to 18 months post-CPX. Continuous and dichotomous expressions of the VE/VCO(2) slope remained prognostically significant up to 36 months post-CPX, whereas peak VO(2) was not predictive during the third and fourth year of follow-up. In a multivariate analysis, the VE/VCO(2) slope was consistently the superior prognostic marker, whereas peak VO(2) added predictive value and was retained in the regression up to 18 months post-CPX. CONCLUSIONS: These results indicate that commonly assessed CPX variables retain prognostic value for at least 2 years. The VE/VCO(2) slope is the superior predictor of adverse events throughout follow-up, although peak VO(2) provides additive prognostic information during the first 2 years of follow-up. |
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Authors:
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Ross Arena; Jonathan Myers; Joshua Abella; Sherry Pinkstaff; Peter Brubaker; Dalane Kitzman; Mary Ann Peberdy; Daniel Bensimhon; Paul Chase; Daniel E Forman; Marco Guazzi |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural Date: 2010-03-03 |
Journal Detail:
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Title: Circulation. Heart failure Volume: 3 ISSN: 1941-3297 ISO Abbreviation: Circ Heart Fail Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-20 Completed Date: 2010-07-15 Revised Date: 2012-05-17 |
Medline Journal Info:
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Nlm Unique ID: 101479941 Medline TA: Circ Heart Fail Country: United States |
Other Details:
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Languages: eng Pagination: 405-11 Citation Subset: IM |
Affiliation:
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Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA 23298, USA. raarena@vcu.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Carbon Dioxide / metabolism Cohort Studies Exercise Test* Female Heart Failure / diagnosis*, mortality, physiopathology* Humans Male Middle Aged Oxygen Consumption / physiology Predictive Value of Tests Prognosis Pulmonary Ventilation / physiology* Survival Analysis Time Factors |
| Grant Support | |
ID/Acronym/Agency:
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P60 AG010484-10/AG/NIA NIH HHS; P60AG10484/AG/NIA NIH HHS; R37 AG018915/AG/NIA NIH HHS; R37 AG018915-10/AG/NIA NIH HHS; R37AG18915/AG/NIA NIH HHS |
| Chemical | |
Reg. No./Substance:
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124-38-9/Carbon Dioxide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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