Document Detail


Modest increase in peak VO2 is related to better clinical outcomes in chronic heart failure patients: results from heart failure and a controlled trial to investigate outcomes of exercise training.
MedLine Citation:
PMID:  22773109     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The prognostic ability of a single measurement of peak oxygen uptake (VO(2)) is well established in patients with chronic heart failure. The relation between a change in peak VO(2) and clinical outcomes is not well defined.
METHODS AND RESULTS: This investigation determined whether an increase in peak VO(2) was associated with a lower risk of the primary end point of time to all-cause mortality or all-cause hospitalization and 3 secondary end points. In Heart Failure and a Controlled Trial to Investigate Outcomes of Exercise Training, an exercise training trial for patients with systolic heart failure, cardiopulmonary exercise tests were performed at baseline and ≈3 months later in 1620 participants. Median peak VO(2) in the combined sample increased from 15.0 (11.9-18.0 Q1-Q3) to 15.4 (12.3-18.7 Q1-Q3) mL·kg(-1)·min(-1). Every 6% increase in peak VO(2,) adjusted for other significant predictors, was associated with a 5% lower risk of the primary end point (hazard ratio=0.95; CI=0.93-0.98; P<0.001); a 4% lower risk of the secondary end point of time to cardiovascular mortality or cardiovascular hospitalization (hazard ratio=0.96; CI=0.94-0.99; P<0.001); an 8% lower risk of cardiovascular mortality or heart failure hospitalization (hazard ratio=0.92; CI=0.88-0.96; P<0.001); and a 7% lower all-cause mortality (hazard ratio=0.93; CI=0.90-0.97; P<0.001).
CONCLUSIONS: Among patients with chronic systolic heart failure, a modest increase in peak VO(2) over 3 months was associated with a more favorable outcome. Monitoring the change in peak VO(2) for such patients may have benefit in assessing prognosis.
Authors:
Ann M Swank; John Horton; Jerome L Fleg; Gregg C Fonarow; Steven Keteyian; Lee Goldberg; Gene Wolfel; Eileen M Handberg; Dan Bensimhon; Marie-Christine Illiou; Marianne Vest; Greg Ewald; Gordon Blackburn; Eric Leifer; Lawton Cooper; William E Kraus;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2012-07-06
Journal Detail:
Title:  Circulation. Heart failure     Volume:  5     ISSN:  1941-3297     ISO Abbreviation:  Circ Heart Fail     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-19     Completed Date:  2012-12-03     Revised Date:  2013-09-03    
Medline Journal Info:
Nlm Unique ID:  101479941     Medline TA:  Circ Heart Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  579-85     Citation Subset:  IM    
Affiliation:
Exercise Physiology Laboratory University of Louisville, Louisville, KY 40292, USA. swank@louisville.edu
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00047437
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MeSH Terms
Descriptor/Qualifier:
Aged
Chronic Disease
Exercise Test
Exercise Therapy*
Exercise Tolerance*
Female
Heart Failure, Systolic / diagnosis,  mortality,  physiopathology,  therapy*
Hospitalization
Humans
Male
Middle Aged
Oxygen Consumption*
Predictive Value of Tests
Proportional Hazards Models
Recovery of Function
Risk Assessment
Risk Factors
Survival Analysis
Time Factors
Treatment Outcome
United States
Grant Support
ID/Acronym/Agency:
5U01HL063747/HL/NHLBI NIH HHS; 5U01HL064250/HL/NHLBI NIH HHS; 5U01HL064257/HL/NHLBI NIH HHS; 5U01HL064264/HL/NHLBI NIH HHS; 5U01HL064265/HL/NHLBI NIH HHS; 5U01HL066461/HL/NHLBI NIH HHS; 5U01HL066482/HL/NHLBI NIH HHS; 5U01HL066494/HL/NHLBI NIH HHS; 5U01HL066501/HL/NHLBI NIH HHS; 5U01HL068973/HL/NHLBI NIH HHS; 5U01HL068980/HL/NHLBI NIH HHS; P60AG010484/AG/NIA NIH HHS; R37AG118915/AG/NIA NIH HHS; U01 HL063747/HL/NHLBI NIH HHS
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