Document Detail


Exercise haemodynamic variables rather than ventilatory efficiency indexes contribute to risk assessment in chronic heart failure patients treated with carvedilol.
MedLine Citation:
PMID:  19406866     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To evaluate the prognostic significance of traditional cardiopulmonary exercise testing (CPET) parameters in chronic heart failure (CHF) patients treated with beta-blockers.
METHODS AND RESULTS: A total of 631 CHF patients were followed for cardiovascular death over 3.8 +/- 1.4 years; among them 79 (13%) died. All prognostic CPET parameters were related to outcome at univariate analysis, with haemodynamic-derived parameters [peak systolic blood pressure (SBP), peak circulatory power (CP) = peak oxygen consumption (pVO2) x peak SBP] and exertional oscillatory ventilation (EOV) reaching the highest chi2 (46.5, 40.9, and 22.6, respectively, all with P < 0.0001). Exertional oscillatory ventilation, although associated with high mortality rate (43 vs. 11%, P < 0.001), was detected in 42 (7%) patients. In non-EOV, again both peak SBP and peak CP reached the highest chi2 (30.6, and 21.6, respectively, all with P < 0.0001). Regarding CPET parameters, at multivariable analysis, peak SBP was the strongest risk index both in total and non-EOV populations, with 11% risk reduction every 5 mmHg increase.
CONCLUSION: All traditional CPET risk parameters were informative in beta-blockers CHF patients, but peak SBP, peak CP, and EOV were the most predictive. In this low-risk population, EOV, although underrepresented, considerably enhanced risk stratification, although other ventilatory efficiency indexes provided less impressive predictive content. In large majority of non-EOV patients, peak SBP improved risk evaluation beyond other CPET parameters.
Authors:
Ugo Corrà; Alessandro Mezzani; Andrea Giordano; Enzo Bosimini; Pantaleo Giannuzzi
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  European heart journal     Volume:  30     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-16     Completed Date:  2011-01-11     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  3000-6     Citation Subset:  IM    
Affiliation:
Laboratory for the Analysis of Cardio-Respiratory Signals, Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Via per Revislate, 13, 28010 Veruno (NO), Italy. ugo.corra@fsm
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use*
Carbazoles / therapeutic use*
Chronic Disease
Exercise / physiology*
Female
Heart Failure / drug therapy,  mortality,  physiopathology*
Hemodynamics / drug effects*
Humans
Male
Middle Aged
Oxygen Consumption / physiology
Propanolamines / therapeutic use*
Respiratory Function Tests
Respiratory Insufficiency / physiopathology*
Risk Assessment / methods
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Carbazoles; 0/Propanolamines; 0K47UL67F2/carvedilol
Comments/Corrections
Comment In:
Eur Heart J. 2009 Dec;30(24):2962-4   [PMID:  19561029 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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