Ross Arena1, Marco Guazzi, Jonathan Myers. 1. Department of Physical Therapy, Box 980224, Virginia Commonwealth University, Health Sciences Campus, Richmond, Virginia 23298-0224, United States. raarena@vcu.edu
Abstract
BACKGROUND: The partial pressure of end-tidal carbon dioxide production (P(ET)CO2) at ventilatory threshold (VT) has been shown to be strongly correlated with cardiac output during exercise in patients with heart failure (HF), but few data are available regarding its prognostic utility. AIMS: The purpose of this study was to assess the ability of P(ET)CO2 to predict cardiac-related events in a group of subjects with HF. METHODS: One hundred and thirty subjects diagnosed with compensated HF underwent cardiopulmonary exercise testing (CPX). Peak oxygen consumption (VO2), the minute ventilation-carbon dioxide production (VE/VCO2) slope and P(ET)CO2 were determined. RESULTS: Receiver operating characteristic (ROC) curve analysis revealed that P(ET)CO2 at the ventilatory threshold (VT) was a significant predictor of cardiac-related events (ROC area=0.82, p<0.001). The optimal P(ET)CO2 at a VT threshold value for separating high (< or =) and low (>) risk groups was 36.1 mm Hg (77% sensitivity, 69% specificity). In a multivariate Cox regression analysis, P(ET)CO2 at VT added significant predictive value to the VE/VCO2 slope and peak VO2. CONCLUSION: These results indicate that P(ET)CO2 during CPX is a significant predictor of cardiac-related events in patients with HF. Clinical assessment of this variable in patients with HF undergoing CPX may therefore be warranted.
BACKGROUND: The partial pressure of end-tidal carbon dioxide production (P(ET)CO2) at ventilatory threshold (VT) has been shown to be strongly correlated with cardiac output during exercise in patients with heart failure (HF), but few data are available regarding its prognostic utility. AIMS: The purpose of this study was to assess the ability of P(ET)CO2 to predict cardiac-related events in a group of subjects with HF. METHODS: One hundred and thirty subjects diagnosed with compensated HF underwent cardiopulmonary exercise testing (CPX). Peak oxygen consumption (VO2), the minute ventilation-carbon dioxide production (VE/VCO2) slope and P(ET)CO2 were determined. RESULTS: Receiver operating characteristic (ROC) curve analysis revealed that P(ET)CO2 at the ventilatory threshold (VT) was a significant predictor of cardiac-related events (ROC area=0.82, p<0.001). The optimal P(ET)CO2 at a VT threshold value for separating high (< or =) and low (>) risk groups was 36.1 mm Hg (77% sensitivity, 69% specificity). In a multivariate Cox regression analysis, P(ET)CO2 at VT added significant predictive value to the VE/VCO2 slope and peak VO2. CONCLUSION: These results indicate that P(ET)CO2 during CPX is a significant predictor of cardiac-related events in patients with HF. Clinical assessment of this variable in patients with HF undergoing CPX may therefore be warranted.
Authors: Ross Arena; Marco Guazzi; Jonathan Myers; Paul Chase; Daniel Bensimhon; Lawrence P Cahalin; Mary Ann Peberdy; Euan Ashley; Erin West; Daniel E Forman Journal: Congest Heart Fail Date: 2012-04-26
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Authors: Jonathan Myers; Ricardo Oliveira; Frederick Dewey; Ross Arena; Marco Guazzi; Paul Chase; Daniel Bensimhon; Mary Ann Peberdy; Euan Ashley; Erin West; Lawrence P Cahalin; Daniel E Forman Journal: Circ Heart Fail Date: 2013-02-07 Impact factor: 8.790
Authors: Ricardo B Oliveira; Jonathan Myers; Claudio Gil S Araújo; Ross Arena; Sandra Mandic; Daniel Bensimhon; Joshua Abella; Paul Chase; Marco Guazzi; Peter Brubaker; Brian Moore; Dalane Kitzman; Mary Ann Peberdy Journal: Am J Cardiol Date: 2009-06-18 Impact factor: 2.778
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