The prognostic value of the cardiopulmonary exercise test in patients with heart failure who have been treated with beta-blockers
The prevalence of chronic heart failure and a reduced ejection fraction (CHF-REF) has increased over the last decade. The cardiopulmonary exercise test (CPET) is an established tool for managing these patients. For patients who are administered beta-blockers, its predictive value is debated. The aim...
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Published in | Türk Kardiyoloji Derneği arşivi Vol. 41; no. 2; pp. 105 - 112 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Turkey
KARE Publishing
01.03.2013
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Subjects | |
Online Access | Get full text |
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Summary: | The prevalence of chronic heart failure and a reduced ejection fraction (CHF-REF) has increased over the last decade. The cardiopulmonary exercise test (CPET) is an established tool for managing these patients. For patients who are administered beta-blockers, its predictive value is debated. The aim of this study was to assess the prognostic values of several parameters in patients with CHF-REF who were on beta-blockers.
390 patients with CHF-REF underwent CPET after cardiac rehabilitation and were followed for two years.
The primary endpoints were all-cause mortality, cardiac-related mortality and major cardiovascular events (hospitalization for HF, heart transplantation and acute coronary syndrome or arrhythmia). The mean beta-blockers dosage was 68.9% of the target dose. The two-year mortality rate was 13%, while the mean age of the population was 57.1 years. In addition, most of the patients were men (85.5% vs. 14.5%). The resting LVEF was 35.7 ± 9.4 and the maximal oxygen uptake (peak VO₂) was 19.5 ml/kg/min. The peak VO₂, VE/VCO₂ slope and circulatory power were significant predictors of risk. The prognosis was better when the initial linear VE/VCO₂ slope was lower than 30, and the final steeper VE/VCO₂ slope was lower than 32. There was no difference between the two slopes. The oxygen uptake efficiency slope, oxygen uptake, heart rate recovery, VE/VCO₂/VO₂ index and ventilatory threshold had no prognostic value.
The peak VO₂, circulatory power and VE/VCO₂ slope were prognostic indicators for patients with CHF-REF who were on beta-blockers. |
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ISSN: | 1016-5169 1016-5169 |
DOI: | 10.5543/tkda.2013.87404 |