Predictive Ability of Cardiopulmonary Exercise Test Parameters in Heart Failure Patients with Cardiac Resynchronization Therapy.
In: Arquivos brasileiros de cardiologia, Jg. 119 (2022-09-01), Heft 3, S. 413-423
academicJournal
Zugriff:
Background: There is evidence suggesting that a peak oxygen uptake (pVO2) cut-off of 10ml/kg/min provides a more precise risk stratification in cardiac resynchronization therapy (CRT) patients.
Objective: To compare the prognostic power of several cardiopulmonary exercise testing (CPET) parameters in this population and assess the discriminative ability of the guideline-recommended pVO2cut-off values.
Methods: Prospective evaluation of consecutive heart failure (HF) patients with left ventricular ejection fraction ≤40%. The primary endpoint was a composite of cardiac death and urgent heart transplantation (HT) in the first 24 follow-up months, and was analysed by several CPET parameters for the highest area under the curve (AUC) in the CRT group. A survival analysis was performed to evaluate the risk stratification provided by several different cut-offs. p values <0.05 were considered significant.
Results: A total of 450 HF patients, of which 114 had a CRT device. These patients had a higher baseline risk profile, but there was no difference regarding the primary outcome (13.2% vs 11.6%, p =0.660). End-tidal carbon dioxide pressure at anaerobic threshold (PETCO2AT)had the highest AUC value, which was significantly higher than that of pVO2in the CRT group (0.951 vs 0.778, p =0.046). The currently recommended pVO2cut-off provided accurate risk stratification in this setting (p <0.001), and the suggested cut-off value of 10 ml/min/kg did not improve risk discrimination in device patients (p =0.772).
Conclusion: PETCO2ATmay outperform pVO2's prognostic power for adverse events in CRT patients. The current guideline-recommended pVO2 cut-off can precisely risk-stratify this population.
Titel: |
Predictive Ability of Cardiopulmonary Exercise Test Parameters in Heart Failure Patients with Cardiac Resynchronization Therapy.
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Autor/in / Beteiligte Person: | Reis, JF ; Gonçalves, AV ; Brás, PG ; Moreira, RI ; Rio, P ; Timóteo, AT ; Soares, RM ; Ferreira, RC |
Zeitschrift: | Arquivos brasileiros de cardiologia, Jg. 119 (2022-09-01), Heft 3, S. 413-423 |
Veröffentlichung: | Sao Paulo : Sociedad Brasileira De Cardiologia, 2022 |
Medientyp: | academicJournal |
ISSN: | 1678-4170 (electronic) |
DOI: | 10.36660/abc.20210620 |
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