| Exercise haemodynamic variables rather than ventilatory efficiency indexes contribute to risk assessment in chronic heart failure patients treated with carvedilol. | |
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MedLine Citation:
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PMID: 19406866 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Ugo Corrà; Alessandro Mezzani; Andrea Giordano; Enzo Bosimini; Pantaleo Giannuzzi |
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Publication Detail:
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Type: Evaluation Studies; Journal Article |
Journal Detail:
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Title: European heart journal Volume: 30 ISSN: 1522-9645 ISO Abbreviation: Eur. Heart J. Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2009-12-16 Completed Date: 2011-01-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 3000-6 Citation Subset: IM |
Affiliation:
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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 |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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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:
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0/Adrenergic beta-Antagonists; 0/Carbazoles; 0/Propanolamines; 72956-09-3/carvedilol |
| Comments/Corrections | |
Comment In:
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Eur Heart J. 2009 Dec;30(24):2962-4
[PMID:
19561029
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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