Document Detail

Peak exercise oxygen pulse and prognosis in chronic heart failure.
MedLine Citation:
PMID:  14996584     Owner:  NLM     Status:  MEDLINE    
Cardiopulmonary variables, particularly peak oxygen consumption (peak VO(2)) corrected for total and lean body weight, have been confirmed to predict prognosis in patients with chronic systolic heart failure (HF). Only limited data are available on the prognostic ability of maximal oxygen (O(2)) pulse, an indicator of stroke volume and arteriovenous O(2) difference, especially when corrected for lean body mass. Cardiopulmonary exercise tests were performed in 209 consecutive patients with mild-to-moderate HF (mean ejection fraction 23%), followed for 19 +/- 12 months to determine the impact of maximal O(2) pulse in relation to other cardiopulmonary variables on major clinical events (13 cardiovascular deaths and 15 urgent transplantations). Compared with patients with clinical events, those without major events had a higher peak O(2) pulse (11.4 +/- 4.1 vs 9.2 +/- 2.3 ml/beat, p <0.0001) and body fat-adjusted peak O(2) pulse (15.6 +/- 5.6 vs 11.9 +/- 3.4 ml/beat, p <0.0001). In multivariate analysis, a low peak O(2) pulse was the strongest independent predictor of clinical events (chi-square 10.5, p <0.01). Although peak O(2) pulse was a stronger predictor for clinical events than any other exercise cardiopulmonary variable, including peak VO(2), peak VO(2) lean (defined as the VO(2) corrected for lean body mass), and percentage of predicted peak VO(2), this relation was further strengthened by correcting peak O(2) pulse for percent body fat (chi-square 12.4, p <0.001). In most subgroups (including women, obese subjects, those receiving beta blockers, and those with class III HF), peak O(2) pulse lean was similar to or superior to peak VO(2) lean for predicting major clinical events. Especially in patients who were class III HF and who were receiving beta blockers, peak VO(2) (cutoff 14 ml/kg/min) poorly predicted prognosis; risk stratification was best with peak O(2) pulse lean (cutoff 14 ml/beat). These data indicate the potential usefulness of peak O(2) pulse and lean body mass-adjusted O(2) pulse for predicting prognosis in patients with systolic HF.
Carl J Lavie; Richard V Milani; Mandeep R Mehra
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  93     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-03-03     Completed Date:  2004-04-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  588-93     Citation Subset:  AIM; IM    
Departmentof Cardiology, Ochsner Clinic Foundation, New Orleans, Louisiana 70121, USA.
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MeSH Terms
Blood Pressure / physiology
Exercise / physiology*
Exercise Test
Heart Failure / metabolism*,  physiopathology
Heart Rate / physiology
Middle Aged
Oxygen Consumption / physiology*
Retrospective Studies
Stroke Volume / physiology

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