| Ventilatory Power: A Novel Index that Enhances Prognostic Assessment of Patients with Heart Failure. | |
| | |
MedLine Citation:
|
PMID: 22899767 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
BACKGROUND: -Ventilatory efficiency (VE/VCO2 slope) is an index determined by cardiopulmonary exercise testing (CPX) which incorporates pertinent cardiac, pulmonary, and skeletal muscle physiology into a substantive composite assessment. The VE/VCO(2) slope has many applications, including utility as a well-validated prognostic gauge for heart failure (HF) patients. In this study, we combine VE/VCO(2) slope with systolic blood pressure (SBP), creating a novel index that we labeled "ventilatory power." Ventilatory power links the combined physiology inherent in the VE/VCO(2) slope to peripheral pressure, adding an additional dimension pertinent to HF assessment. Whereas the related concept of circulatory power links peak oxygen consumption (VO(2)) with peak SBP as a prognostic index, we hypothesized that ventilatory power would provide greater prognostic discrimination than VE/VO(2) slope, peak VO(2), and/or circulatory power for systolic heart failure (HF) patients. METHODS AND RESULTS: -Systolic HF patients (left ventricular ejection fraction [LVEF] ≤35%) underwent symptom-limited CPX as part of routine management and were followed for up to four years for major cardiac events (mortality, left ventricular assist device [LVAD] implantation, and heart transplantation). 875 HF patients (LVEF 26±9%; mean age 55±14) were studied. CPX indices peak VO(2), VE/VCO(2) slope, circulatory power and ventilatory power were all predictive of cardiac events (p <0.001). Multivariate analysis demonstrated that ventilatory power was the strongest indicator of prognosis. CONCLUSIONS: -While circulatory power and traditional CPX parameters can be used to predict prognosis among HF patients, ventilatory power provides relatively greater prognostic discrimination and may constitute a relatively more useful composite tool. |
| | |
Authors:
|
Daniel E Forman; Marco Guazzi; Jonathan Myers; Paul Chase; Daniel Bensimhon; Lawrence P Cahalin; Mary Ann Peberdy; Euan Ashley; Erin West; Karla M Danels; Ross Arena |
Related Documents
:
|
22564267 - Quantitative assessment of the left atrial myocardial deformation in patients with chro... 21805577 - Percutaneous revascularization of left main: role of imaging, techniques and adjunct ph... 22115657 - Fractional flow reserve in unstable angina and non-st-segment elevation myocardial infa... 22704867 - Left ventricular non-compaction: prevalence in congenital heart disease. 19768177 - Having a change of heart: reversing the suicidal proclivities of cardiac myocytes. 21342247 - Is red wine a safe sip away from cardioprotection? mechanisms involved in resveratrol- ... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2012-8-16 |
Journal Detail:
|
Title: Circulation. Heart failure Volume: - ISSN: 1941-3297 ISO Abbreviation: Circ Heart Fail Publication Date: 2012 Aug |
Date Detail:
|
Created Date: 2012-8-17 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101479941 Medline TA: Circ Heart Fail Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
1 Brigham and Women's Hospital, Boston, MA; |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Cystatin C identifies patients with stable chronic heart failure at increased risk for adverse cardi...
Next Document: Current Outcomes in US Children with Cardiomyopathy Listed for Heart Transplantation.