Document Detail


Ventilatory expired gas at constant-rate low-intensity exercise predicts adverse events and is related to neurohormonal markers in patients with heart failure.
MedLine Citation:
PMID:  19643358     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Ventilatory efficiency (VE/VCO(2) ratio) and the partial pressure of end-tidal carbon dioxide (P(ET)CO(2)), obtained during moderate to high levels of physical exertion demonstrate prognostic value in heart failure (HF). The present investigation assesses the clinical utility of these variables during low-intensity exercise.
METHODS AND RESULTS: One hundred and thirty subjects diagnosed with HF underwent a 2-minute, constant-rate treadmill session at 2 miles per hour. Both the VE/VCO(2) ratio and P(ET)CO(2) were recorded during exercise (30-second average) and their change (Delta) from rest. B-type and atrial natriuretic peptide (BNP and ANP) were also determined. Only P(ET)CO(2) and DeltaP(ET)CO(2) emerged from the multivariate Cox regression. Receiver operating characteristic curve analysis revealed the prognostic classification schemes were significant with thresholds of < or >or=34 mm Hg (hazard ratio: 4.2, 95% CI: 2.2-8.0, P < .001) and < or >or=1 mm Hg (hazard ratio: 3.5, 95% CI: 1.9-6.6, P < .001) being optimal for P(ET)CO(2) and DeltaP(ET)CO(2), respectively. Moreover, subjects with a P(ET)CO(2)>or=34 mm Hg had a significantly lower BNP (214.1 +/- 431.9 vs. 1110.5 +/- 1854.0 pg/mL, P=.005) and ANP (108.2 +/- 103.6 vs. 246.2 +/- 200.4 pg/mL, P < .001).
CONCLUSIONS: The results of this pilot study indicate ventilatory expired gas analysis during a short bout of low-intensity exercise may provide insight into prognosis and cardiac stability.
Authors:
Ross Arena; Dean MacCarter; Thomas P Olson; Sophie Lalande; Maile L Ceridon; Lyle J Olson; Bruce Johnson
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-02-10
Journal Detail:
Title:  Journal of cardiac failure     Volume:  15     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-31     Completed Date:  2010-04-19     Revised Date:  2014-09-18    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  482-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Biological Markers / blood
Exercise / physiology*
Exercise Test / methods
Exercise Tolerance / physiology
Female
Heart Failure / blood*,  complications,  physiopathology*
Humans
Male
Middle Aged
Neurotransmitter Agents / blood*
Oxygen Consumption / physiology
Pilot Projects
Predictive Value of Tests
Pulmonary Ventilation / physiology*
Grant Support
ID/Acronym/Agency:
R01 HL071478/HL/NHLBI NIH HHS; R01 HL071478-06A2/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Neurotransmitter Agents
Comments/Corrections

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