| Submaximal exercise gas exchange is an important prognostic tool to predict adverse outcomes in heart failure. | |
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MedLine Citation:
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PMID: 21036777 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: Traditionally, VO(2peak) has been used to determine prognosis in heart failure; however, this measure has limitations. Hence, other exercise and gas exchange parameters measured submaximally, e.g. breathing efficiency (V(E)/VCO(2)), end-tidal CO(2) (P(ET)CO(2)), oxygen uptake efficiency slope (OUES), and circulatory power [ systolic blood pressure (SBP)], have been investigated. The aim of this study was to investigate the prognostic relevance of submaximal exercise gas exchange in heart failure patients. Method and results One hundred and thirty-two consecutive heart failure patients (mean age 56 ± 12 years, ejection fraction 29 ± 11%) performed peak treadmill testing. Gas exchange and haemodynamic variables were measured continuously. Gas exchange data obtained from the first 2 min of exercise and at a respiratory exchange ratio (RER) of 0.9 were the measurements of interest. Over a median follow-up period of 62.4 (range 0-114) months, there were 44 endpoints (death or transplant). Univariate analysis demonstrated submaximal predictors of survival, which included V(E)/VCO(2) slope and ratio, P(ET)CO(2), OUES, and circulatory power (P ≤ 0.01). When these and additional submaximal variables were included together in the multivariable analysis, the strongest submaximal exercise predictive model (C-statistic 0.75) comprised data from the first stage of exercise (V(E) and circulatory power) and at an RER of 0.9 (V(E)/VCO(2) ratio). The inclusion of VO(2 peak) and demographic data, with submaximal data (V(E)/VCO(2) ratio at an RER = 0.9), increased the predictiveness of the model (C-statistic 0.78). CONCLUSION: Submaximal exercise measures provide useful prognostic information for predicting survival in heart failure. This form of testing is logistically easier, cheaper, and safer for patients compared with maximal exercise. |
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Authors:
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Paul R Woods; Kent R Bailey; Christina M Wood; Bruce D Johnson |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2010-10-29 |
Journal Detail:
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Title: European journal of heart failure Volume: 13 ISSN: 1879-0844 ISO Abbreviation: Eur. J. Heart Fail. Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-02-21 Completed Date: 2011-06-23 Revised Date: 2013-05-20 |
Medline Journal Info:
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Nlm Unique ID: 100887595 Medline TA: Eur J Heart Fail Country: Netherlands |
Other Details:
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Languages: eng Pagination: 303-10 Citation Subset: IM |
Affiliation:
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Division of Cardiovascular Disease, Mayo Clinic, Joseph 4-225D, Rochester, MN 55902, USA. woods.paul@mayo.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Analysis of Variance Exercise Test / methods* Female Follow-Up Studies Heart Failure / diagnosis*, mortality Humans Kaplan-Meier Estimate Male Middle Aged Prognosis Proportional Hazards Models Pulmonary Gas Exchange* |
| Grant Support | |
ID/Acronym/Agency:
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HL71478/HL/NHLBI NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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