Document Detail


Ventilatory variables are strong prognostic markers in elderly patients with heart failure.
MedLine Citation:
PMID:  12181213     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the safety and prognostic capacity of cardiopulmonary exercise testing in patients > or = 60 years old who are hospitalised with heart failure caused by left ventricular dysfunction.
DESIGN: Prospective study.
SETTING: University hospital.
PATIENTS: Study participants were 67 patients (66% men) with clinical heart failure stabilised on medical treatment. The study is a part of a nursing intervention study. Mean (SD) age was 74 (6) years, New York Heart Association functional class II-III, and ejection fraction 0.36 (0.11).
INTERVENTIONS: Cardiopulmonary exercise testing and echocardiography.
MAIN OUTCOME MEASURES: Peak oxygen consumption (VO2), peak ventilatory equivalents for carbon dioxide (VE/VCO2) and oxygen (VE/VO2), left ventricular volumes, and mortality.
RESULTS: Mean (SD) peak VO2 was 11.7 (3.7) ml/kg/min, peak VE/VCO2 43 (9), and peak VE/VO2 46 (11). During 12-59 months of follow up, 14 patients died. In univariate analyses peak VO2, VE/VO2, and VE/VCO2 were all strongly related (p < 0.01) to mortality. In a multivariate Cox regression analysis, peak VE/VCO2 was the strongest predictor of mortality (p < 0.001), followed by left ventricular end systolic volume (p < 0.001). A cut off of peak VE/VCO2 at > or = 45 gave a univariate hazard ratio of 6.7 for death during follow up. No adverse events occurred during the exercise test.
CONCLUSION: These findings extend results found in selected middle aged patients to elderly patients with heart failure and show that ventilatory parameters from a cardiopulmonary exercise test, such as peak VO2, VE/O2, and VE/VCO2 are powerful predictors of mortality.
Authors:
M Mejhert; E Linder-Klingsell; M Edner; T Kahan; H Persson
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  88     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-08-15     Completed Date:  2002-09-20     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  239-43     Citation Subset:  AIM; IM    
Affiliation:
Section of Cardiology, Division of Internal Medicine, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden. marit.mejhert@med.ds.sll.se
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MeSH Terms
Descriptor/Qualifier:
Aged
Echocardiography / methods
Exercise Test
Female
Heart Failure / physiopathology*
Humans
Male
Oxygen Consumption
Prognosis
Prospective Studies
Pulmonary Gas Exchange
Survival Analysis
Ventricular Dysfunction, Left / physiopathology*
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