Prognostic Value of Timing and Duration Characteristics of Exercise Oscillatory Ventilation in Patients With Heart Failure

• Published in: The Journal of heart and lung transplantation Vol. 27; no. 3; pp. 341 - 347
• Main Authors: Arena, Ross, PhD, PT, Myers, Jonathan, PhD, Abella, Joshua, MD, Peberdy, Mary Ann, MD, Pinkstaff, Sherry, BA, DPT, Bensimhon, Daniel, MD, Chase, Paul, MEd, Guazzi, Marco, MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2008; Elsevier Science
• Subjects: Adult; Biological and medical sciences; Cardiology. Vascular system; Exercise Test; Female; Heart; Heart Failure - complications; Heart Failure - diagnosis; Heart Failure - physiopathology; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Humans; Linear Models; Male; Medical sciences; Middle Aged; Multivariate Analysis; Oxygen Consumption - physiology; Predictive Value of Tests; Prognosis; Pulmonary Ventilation - physiology; Respiratory Mechanics - physiology; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Tidal Volume - physiology; Physical exercise; Human; Heart failure; Prognosis; Characteristic; Cardiovascular disease; Patient; Duration; Phlebology; Characteristics; Heart disease; Exercise tolerance test; Ventilation; Circulatory system; Timing; Cardiology
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2007.11.574

Background Exercise oscillatory ventilation (EOV) occurs in a sub-group of patients with increased heart failure (HF) severity and poorer prognosis. The purpose of this investigation was to examine the prognostic value of the largest ventilatory oscillation characteristics in HF patients. Methods One hundred fifty-four subjects diagnosed with HF underwent cardiopulmonary exercise testing. Subjects with EOV were then divided into two sub-groups: (1) largest ventilatory oscillation during the first half of exercise with an oscillation width ≥30 seconds; and (2) largest ventilatory oscillation during the second half of exercise or an oscillation width <30 seconds. Subjects were tracked for major cardiac events after the exercise test. Results The fifty-five subjects (35.7%) in the overall group demonstrating EOV during the exercise test were at significantly higher risk for adverse events (hazard ratio = 3.0, 95% confidence interval 1.6 to 5.5, p < 0.001). The prognostic value of this ventilatory phenomenon improved when only subjects with the largest ventilatory oscillation during the first half of exercise with an oscillation width ≥30 seconds were defined as having EOV (hazard ratio = 3.6, 95% confidence interval 1.6 to 7.9, p = 0.002). Conclusions In this study we found that the characteristics of the largest oscillatory ventilation provide valuable prognostic information in patients with EOV.