Document Detail


Relation of the prognostic value of ventilatory efficiency to body mass index in patients with heart failure.
MedLine Citation:
PMID:  18237598     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The ventilatory efficiency, minute ventilation (VE)/carbon dioxide production (VCO2), slope consistently provides valuable prognostic information in patients with heart failure (HF). Patients with a higher body mass index (BMI) have demonstrated an improved prognosis in the HF population, a phenomenon that has been termed the "obesity paradox." The purpose of this study was to evaluate the prognostic ability of the VE/VCO2 slope according to BMI in patients with HF. Seven-hundred four patients with HF (555 men, 149 women, mean age 56.8+/-13.4 years, ejection fraction 33.1+/-13.3%) with a BMI>or=18.5 kg/m2 underwent cardiopulmonary exercise testing. Subjects were divided into 3 BMI subgroups (18.5 to 24.9, 25.0 to 29.9, and >or=30 kg/m2). Each subject was tracked for major cardiac events (death, transplantation, left ventricular assist device implantation) for 2 years after testing. There were 86 major cardiac events (71 deaths, 10 transplantations, 5 left ventricular assist device implantations) during the 2-year tracking period (overall annual event rate 8.2%). The VE/VCO2 slope was the strongest prognostic marker in each BMI subgroup. Subjects in the highest BMI group had the lowest mean VE/VCO2 slope and the lowest rate of major cardiac events of the 3 groups. Multivariate Cox regression analysis showed that peak VO2 did not add additional prognostic value to the VE/VCO2 slope and was removed from the regression for each BMI subgroup. In conclusion, the findings of the present study indicate that VE/VCO2 slope maintains prognostic value irrespective of BMI in patients with HF.
Authors:
Paul Chase; Ross Arena; Jonathan Myers; Joshua Abella; Mary Ann Peberdy; Marco Guazzi; Daniel Bensimhon
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Publication Detail:
Type:  Journal Article     Date:  2007-12-21
Journal Detail:
Title:  The American journal of cardiology     Volume:  101     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-01     Completed Date:  2008-03-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  348-52     Citation Subset:  AIM; IM    
Affiliation:
LeBauer Cardiovascular Research Foundation, Greensboro, North Carolina, USA. paul.chase@mosescone.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Body Mass Index*
Carbon Dioxide / metabolism
Comorbidity
Exercise Test
Female
Heart Failure / epidemiology,  physiopathology*
Humans
Male
Middle Aged
Obesity / epidemiology,  physiopathology
Oxygen Consumption / physiology
Prognosis
Pulmonary Ventilation / physiology*
ROC Curve
Regression Analysis
Stroke Volume
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

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


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