Document Detail


Ischemic etiology of heart failure identifies patients with more severely impaired exercise capacity.
MedLine Citation:
PMID:  16186059     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Peak oxygen uptake (peak VO2) and the regression slope of ventilation against CO2 production during exercise (VE/VCO2 slope) are powerful prognostic indicators in patients with chronic heart failure (CHF). Our purpose was to evaluate the influence of CHF etiology on peak VO2 and VE/VCO2 slope, independently of demographic, clinical, Doppler-echocardiographic and neurohormonal factors. METHODS: Data were collected from 239 CHF patients referred for a cardiopulmonary exercise test as part of their clinical evaluation. Patients were stratified according to their CHF etiology (ischemic versus non-ischemic). RESULTS: The etiology of heart failure was ischemic in 143 patients (60%) and non-ischemic in 96 (40%). Patients with ischemic etiology, compared with those with non-ischemic etiology, showed a lower peak VO2 (15.4+/-4.2 versus 17.8+/-4.8 ml/kg/min, p<0.0001) and a steeper VE/VCO2 slope (38.1+/-6.8 versus 34+/-5.3, p<0.0001). In the univariate model, age (r=-0.36, p<0.0001), female sex (r=-0.21, p=0.001), ischemic CHF etiology (r=-0.26, p<0.0001) and NYHA class (r=-0.52, p<0.0001) correlated with peak VO2. At multivariate analysis, ischemic CHF etiology (beta=-0.23, p=0.001) was a predictor of peak VO2 (R(2)=0.49) independently of age (beta=-0.23, p=0.001), female sex (beta=-0.25, p=0.0006) and NYHA class (beta=-0.31, p<0.0001). Similarly, ischemic etiology (beta=0.29, p=0.001) predicted the VE/VCO2 slope (R(2)=0.38) independently of E/A ratio (beta=0.27, p=0.01) and resting heart rate (beta=0.22, p=0.01). CONCLUSIONS: Etiology of heart failure may influence the functional capacity and the ventilatory response to exercise.
Authors:
Stefania De Feo; Lorenzo Franceschini; Giovanna Brighetti; Mariantonietta Cicoira; Luisa Zanolla; Andrea Rossi; Giorgio Golia; Piero Zardini
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  104     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-09-27     Completed Date:  2006-02-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  292-7     Citation Subset:  IM    
Affiliation:
Divisione Clinicizzata di Cardiologia, Ospedale Civile Maggiore Piazzale Stefani 1, I-37126 Verona, Italy. stefania.defeo@tiscali.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aldosterone / blood
Blood Flow Velocity / physiology
Blood Pressure / physiology
Echocardiography
Epinephrine / blood
Exercise Test
Exercise Tolerance / physiology*
Female
Heart Failure / etiology,  physiopathology*,  ultrasonography
Heart Rate / physiology
Humans
Male
Middle Aged
Mitral Valve / physiopathology,  ultrasonography
Multivariate Analysis
Myocardial Ischemia / etiology,  physiopathology*,  ultrasonography
Neurotransmitter Agents / blood
Norepinephrine / blood
Oxygen Consumption / physiology
Predictive Value of Tests
Severity of Illness Index
Stroke Volume / physiology
Ventricular Dysfunction, Left / etiology,  physiopathology,  ultrasonography
Chemical
Reg. No./Substance:
0/Neurotransmitter Agents; 51-41-2/Norepinephrine; 51-43-4/Epinephrine; 52-39-1/Aldosterone

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