Document Detail


Prognostic impact of peakVO2-changes in stable CHF on chronic beta-blocker treatment.
MedLine Citation:
PMID:  17222927     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Peak oxygen uptake (pVO2) is used for risk stratification in chronic heart failure (CHF), but little is known about the prognostic impact of pVO2-changes in patients on chronic beta-blocker (BBL) therapy. We therefore prospectively evaluated individual pVO2-changes at a 6-month interval in patients all receiving BBL. METHODS: 194 patients with stable CHF on stable medication were included (V1) and underwent clinical evaluation and exercise testing. Testing was repeated (V2) at 5.7+/-1.5 months after V1 and patients were followed >12 months after V2. Death or hospitalisation due to cardiac reasons was the predefined EP (EPP, end-point positive; n=62; EPN, end-point negative; n=113). RESULTS: Initial characteristics did not differ between EPP and EPN. Multivariate cox regression analysis revealed that change of pVO2 (EPP: -0.6+/-2.6 ml/kg min; EPN: +2.5+/-3.3 ml/kg min; p<0.001) was independent to pVO2, LVEF, NTproBNP and NYHA at V2 for prediction of the combined end-point during follow-up. An increase of pVO2 by 10% was identified as an adequate cut-off value for risk stratification and ROC-analysis showed the significant incremental prognostic value of the determination of pVO2 changes in combination with pVO2. CONCLUSIONS: Serial measurements of pVO2 yield additional information for risk stratification in clinically homogenous CHF patients receiving BBL. This is the first study demonstrating this fact within a narrow predefined interval with all patients on BBL.
Authors:
L Frankenstein; M Nelles; M Hallerbach; D Dukic; A Fluegel; D Schellberg; H A Katus; A Remppis; C Zugck
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-01-12
Journal Detail:
Title:  International journal of cardiology     Volume:  122     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-16     Completed Date:  2007-11-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  125-30     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Angiology, Pulmonology, University of Heidelberg, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany. Lutz.Frankenstein@med.uni-heidelberg.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Chi-Square Distribution
Disease Progression
Exercise Test
Female
Heart Failure / drug therapy*,  physiopathology*
Humans
Male
Middle Aged
Multivariate Analysis
Oxygen Consumption*
Prognosis
Prospective Studies
ROC Curve
Risk Assessment

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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