| Ischemic etiology of heart failure identifies patients with more severely impaired exercise capacity. | |
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MedLine Citation:
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PMID: 16186059 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Stefania De Feo; Lorenzo Franceschini; Giovanna Brighetti; Mariantonietta Cicoira; Luisa Zanolla; Andrea Rossi; Giorgio Golia; Piero Zardini |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: International journal of cardiology Volume: 104 ISSN: 0167-5273 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2005 Oct |
Date Detail:
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Created Date: 2005-09-27 Completed Date: 2006-02-28 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: Ireland |
Other Details:
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Languages: eng Pagination: 292-7 Citation Subset: IM |
Affiliation:
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Divisione Clinicizzata di Cardiologia, Ospedale Civile Maggiore Piazzale Stefani 1, I-37126 Verona, Italy. stefania.defeo@tiscali.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Neurotransmitter Agents; 51-41-2/Norepinephrine; 51-43-4/Epinephrine; 52-39-1/Aldosterone |
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