Patricia Palau1, Eloy Domínguez2, Eduardo Núñez3, José María Ramón3, Laura López4, Joana Melero2, Juan Sanchis5, Alejandro Bellver2, Enrique Santas3, Antoni Bayes-Genis6, Francisco J Chorro3, Julio Núñez5. 1. Servicio de Cardiología, Hospital General Universitario de Castellón, Universitat Jaume I, Castellón, Spain. Electronic address: patri.palau@gmail.com. 2. Servicio de Cardiología, Hospital General Universitario de Castellón, Universitat Jaume I, Castellón, Spain. 3. Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA, Universitat de València, Valencia, Spain. 4. Departamento de Fisioterapia, Universitat de València, Valencia, Spain. 5. Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA, Universitat de València, Valencia, Spain; CIBER Cardiovascular, Madrid, Spain. 6. CIBER Cardiovascular, Madrid, Spain; Servicio de Cardiología, Hospital Universitari Germans Trias i Pujol, Badalona, Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.
Abstract
INTRODUCTION AND OBJECTIVES: Heart failure with preserved ejection fraction (HFpEF) is a highly prevalent syndrome with an elevated risk of morbidity and mortality. To date, there is scarce evidence on the role of peak exercise oxygen uptake (peak VO2) for predicting the morbidity burden in HFpEF. We sought to evaluate the association between peak VO2 and the risk of recurrent hospitalizations in patients with HFpEF. METHODS: A total of 74 stable symptomatic patients with HFpEF underwent a cardiopulmonary exercise test between June 2012 and May 2016. A negative binomial regression method was used to determine the association between the percentage of predicted peak VO2 (pp-peak VO2) and recurrent hospitalizations. Risk estimates are reported as incidence rate ratios. RESULTS: The mean age was 72.5 ± 9.1 years, 53% were women, and all patients were in New York Heart Association functional class II to III. Mean peak VO2 and median pp-peak VO2 were 10 ± 2.8mL/min/kg and 60% (range, 47-67), respectively. During a median follow-up of 276 days [interquartile range, 153-1231], 84 all-cause hospitalizations in 31 patients (41.9%) were registered. A total of 15 (20.3%) deaths were also recorded. On multivariate analysis, accounting for mortality as a terminal event, pp-peak VO2 was independently and linearly associated with the risk of recurrent admission. Thus, and modeled as continuous, a 10% decrease of pp-peak VO2 increased the risk of recurrent hospitalizations by 32% (IRR, 1.32; 95%CI, 1.03-1.68; P = .028). CONCLUSIONS: In symptomatic elderly patients with HFpEF, pp-peak VO2 predicts all-cause recurrent admission.
INTRODUCTION AND OBJECTIVES:Heart failure with preserved ejection fraction (HFpEF) is a highly prevalent syndrome with an elevated risk of morbidity and mortality. To date, there is scarce evidence on the role of peak exercise oxygen uptake (peak VO2) for predicting the morbidity burden in HFpEF. We sought to evaluate the association between peak VO2 and the risk of recurrent hospitalizations in patients with HFpEF. METHODS: A total of 74 stable symptomatic patients with HFpEF underwent a cardiopulmonary exercise test between June 2012 and May 2016. A negative binomial regression method was used to determine the association between the percentage of predicted peak VO2 (pp-peak VO2) and recurrent hospitalizations. Risk estimates are reported as incidence rate ratios. RESULTS: The mean age was 72.5 ± 9.1 years, 53% were women, and all patients were in New York Heart Association functional class II to III. Mean peak VO2 and median pp-peak VO2 were 10 ± 2.8mL/min/kg and 60% (range, 47-67), respectively. During a median follow-up of 276 days [interquartile range, 153-1231], 84 all-cause hospitalizations in 31 patients (41.9%) were registered. A total of 15 (20.3%) deaths were also recorded. On multivariate analysis, accounting for mortality as a terminal event, pp-peak VO2 was independently and linearly associated with the risk of recurrent admission. Thus, and modeled as continuous, a 10% decrease of pp-peak VO2 increased the risk of recurrent hospitalizations by 32% (IRR, 1.32; 95%CI, 1.03-1.68; P = .028). CONCLUSIONS: In symptomatic elderly patients with HFpEF, pp-peak VO2 predicts all-cause recurrent admission.
Authors: Justin McNair Canada; Antonio Abbate; Rebecca Collen; Hayley Billingsley; Leo Francis Buckley; Salvatore Carbone; Cory Ross Trankle; Michael Ola Idowu; Dinesh Kadariya; Benjamin Van Tassell; Arun Jayant Sanyal; Mohammad Shadab Siddiqui Journal: Am J Cardiol Date: 2018-11-06 Impact factor: 2.778
Authors: Emily C Gathright; Elena Salmoirago-Blotcher; Julie DeCosta; Marissa L Donahue; Melissa M Feulner; Dean G Cruess; Rena R Wing; Michael P Carey; Lori A J Scott-Sheldon Journal: Health Psychol Date: 2021-09 Impact factor: 5.556