| Exercise oscillatory ventilation may predict sudden cardiac death in heart failure patients. | |
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MedLine Citation:
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PMID: 17659196 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The purpose of this study was to test the ability of cardiopulmonary exercise testing (CPET)-derived variables as sudden cardiac death (SCD) predictors. BACKGROUND: The CPET variables, such as peak oxygen uptake (VO2), ventilatory requirement to carbon dioxide (CO2) production (VE/VCO2) slope, and exercise oscillatory breathing (EOB), are strong predictors of overall mortality in chronic heart failure (CHF) patients. Even though up to 50% of CHF patients die from SCD, it is unknown whether any of these variables predicts SCD. METHODS: One hundred fifty-six CHF patients (mean age: 60.9 +/- 9.4 years; mean ejection fraction: 34.9 +/- 10.6%) underwent CPET. Subjects were tracked for sudden versus pump-failure cardiac mortality over 27.8 +/- 25.2 months. RESULTS: Seventeen patients died from SCD, and 17 died from cardiac pump failure. Survivors showed significantly higher peak VO2 (16.8 +/- 4.5 ml x kg(-1) x min(-1)) and lower VE/VCO2 slope (32.8 +/- 6.4) and prevalence of EOB (20.3%), compared with subjects who experienced arrhythmic (13.5 +/- 3.2 ml x kg(-1) x min(-1); 41.5 +/- 11.4; 100%) or nonarrhythmic (14.1 +/- 4.7 ml x kg(-1) x min(-1); 38.1 +/- 7.3; 47.1%) deaths (p < 0.05). At Cox regression analysis, all variables were significant univariate predictors of both sudden and pump failure death (p < 0.01). Multivariate analysis, including left ventricular (LV) ejection fraction, LV end systolic volume, and LV mass selected EOB, was the strongest predictor of both overall mortality (chi-square: 38.7, p < 0.001) and SCD (chi-square: 44.7, p < 0.001), whereas VE/VCO2 slope was the strongest ventilatory predictor of pump failure death (chi-square: 11.8, p = 0.001). CONCLUSIONS: Exercise oscillatory breathing is an independent predictor of SCD in patients with CHF and might help as an additional marker for prioritization of antiarrhythmic strategies. |
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Authors:
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Marco Guazzi; Rosa Raimondo; Marco Vicenzi; Ross Arena; Chiara Proserpio; Simona Sarzi Braga; Roberto Pedretti |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2007-07-12 |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 50 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2007 Jul |
Date Detail:
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Created Date: 2007-07-30 Completed Date: 2007-08-21 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 299-308 Citation Subset: AIM; IM |
Affiliation:
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Cardiopulmonary Unit, Cardiology Division, University of Milano, San Paolo Hospital, Milano, Italy. marco.guazzi@unimi.it |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Carbon Dioxide
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metabolism Death, Sudden, Cardiac / etiology, prevention & control* Exercise Test / methods* Female Follow-Up Studies Heart Failure / complications*, metabolism, physiopathology* Heart Function Tests Humans Male Middle Aged Multivariate Analysis Oxygen Consumption Predictive Value of Tests Proportional Hazards Models ROC Curve Respiratory Mechanics* Risk Factors |
| 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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