PMID- 18699772
OWN - NLM
STAT- MEDLINE
DCOM- 20090402
LR  - 20191210
IS  - 1470-8736 (Electronic)
IS  - 0143-5221 (Linking)
VI  - 116
IP  - 5
DP  - 2009 Mar
TI  - Additive prognostic value of cardiopulmonary exercise testing in elderly patients 
      with heart failure.
PG  - 415-22
LID - 10.1042/CS20080111 [doi]
AB  - To date, the role of CPET (cardiopulmonary exercise testing) for risk 
      stratification in elderly patients with HF (heart failure) with depressed or 
      preserved ventricular function has not been evaluated. In the present study, we 
      analysed whether CPET is useful in predicting outcome in this population. A total 
      of 220 NYHA (New York Heart Association) class I-III patients with HF > or =70 
      years of age [median age, 75 years; 23% had NYHA class III; and 59% had preserved 
      ventricular systolic function (left ventricular ejection fraction > or =40%)] 
      performed maximal CPET (peak expiratory exchange ratio >1.00). Median peak oxygen 
      uptake was 11.9 ml.kg(-1) of body weight.min(-1), median VE/VCO(2) slope (slope 
      of the minute ventilation/carbon dioxide production ratio) was 33.2 and 45% had 
      an EVR (enhanced ventilatory response) to exercise (VE/VCO(2) slope > or =34). 
      During 19 months of follow-up, 94 patients (43%) met the combined end point of 
      death and hospital admission for worsening HF, arrhythmias or acute coronary 
      syndromes. By Cox multivariable analysis, a creatinine clearance of <50 ml/min 
      HR (hazard ratio), 1.657 [95% CI (confidence interval), 1.055-2.602] and EVR 
      [HR, 1.965 (95% CI, 1.195-3.231)] were the best predictors of outcome, while 
      ventricular function had no influence on prognosis. In conclusion, in elderly 
      patients with HF, a steeper VE/VCO(2) slope provides additional information for 
      risk stratification across the spectrum of ventricular function and identifies a 
      high-risk population, commonly not considered in exercise testing guidelines.
FAU - Scardovi, Angela B
AU  - Scardovi AB
AD  - Department of Cardiology, St Spirito Hospital, Rome, Italy. ab.scardovi@libero.it
FAU - De Maria, Renata
AU  - De Maria R
FAU - Celestini, Andrea
AU  - Celestini A
FAU - Perna, Silvia
AU  - Perna S
FAU - Coletta, Claudio
AU  - Coletta C
FAU - Feola, Mauro
AU  - Feola M
FAU - Aspromonte, Nadia
AU  - Aspromonte N
FAU - Rosso, Gian Luca
AU  - Rosso GL
FAU - Carunchio, Alessandro
AU  - Carunchio A
FAU - Ferraironi, Alessandro
AU  - Ferraironi A
FAU - Pimpinella, Alessandro
AU  - Pimpinella A
FAU - Ricci, Roberto
AU  - Ricci R
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - England
TA  - Clin Sci (Lond)
JT  - Clinical science (London, England : 1979)
JID - 7905731
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 142M471B3J (Carbon Dioxide)
SB  - IM
MH  - Aged
MH  - Anaerobic Threshold
MH  - Carbon Dioxide/physiology
MH  - Epidemiologic Methods
MH  - Exercise Test/*methods
MH  - Female
MH  - Heart Failure/*diagnosis/diagnostic imaging/physiopathology
MH  - Hospitalization
MH  - Humans
MH  - Male
MH  - Natriuretic Peptide, Brain/blood
MH  - Oxygen Consumption/physiology
MH  - Prognosis
MH  - Pulmonary Gas Exchange/physiology
MH  - Stroke Volume/physiology
MH  - Ultrasonography
EDAT- 2008/08/14 09:00
MHDA- 2009/04/03 09:00
CRDT- 2008/08/14 09:00
PHST- 2008/08/14 09:00 [pubmed]
PHST- 2009/04/03 09:00 [medline]
PHST- 2008/08/14 09:00 [entrez]
AID - CS20080111 [pii]
AID - 10.1042/CS20080111 [doi]
PST - ppublish
SO  - Clin Sci (Lond). 2009 Mar;116(5):415-22. doi: 10.1042/CS20080111.