BACKGROUND: A decreased hypercapnic ventilatory response of the overweight patients would lower the ventilation equivalent of carbon dioxide (VE/VCO2) slope but worsen prognosis. The aim of this study was to compare the prognostic ability of the VE/VCO2 slope and peak oxygen consumption (pVO2) between normal and overweight heart failure (HF) patients. METHODS: Prospective evaluation of ambulatory patients with reduced left ventricular ejection fraction who underwent baseline assessment with a cardiopulmonary exercise test. The primary endpoint was cardiac death or urgent heart transplantation in the 5-year period of follow-up. The predictive power of VE/VCO2 slope and pVO2 were compared (area under the curve (AUC) analysis and Hanley & McNeil test), in the subgroups of patients with body mass index (BMI) of 18.5-24.9 kg/m2 and ≥ 25 kg/m2. Statistical differences with a p value < 0.05 were considered significant. RESULTS: There were 270 enrolled patients, with a mean BMI of 27 ± 4 kg/m2. No differences between normal and overweight patients (38.0% vs 29.8%, P=0.170) were found during the 5-year period for the primary endpoint. The VE/VCO2 slope was non-inferior to pVO2 in both groups at 1, 3 and 5 years of follow-up. The comparison of VE/VCO2 slope between groups revealed a significant lower AUC at 3 (0.921 vs 0.787, P=0.022) and 5 years (0.898 vs 0.787, P=0.044) of follow-up for overweight patients. CONCLUSION: Despite VE/VCO2 slope provides a discriminative power at least as good as pVO2 for predicting adverse events in both normal and overweight HF patients, a significant lower predictive power was found in overweight patients. AJCD
BACKGROUND: A decreased hypercapnic ventilatory response of the overweight patients would lower the ventilation equivalent of carbon dioxide (VE/VCO2) slope but worsen prognosis. The aim of this study was to compare the prognostic ability of the VE/VCO2 slope and peak oxygen consumption (pVO2) between normal and overweight heart failure (HF) patients. METHODS: Prospective evaluation of ambulatory patients with reduced left ventricular ejection fraction who underwent baseline assessment with a cardiopulmonary exercise test. The primary endpoint was cardiac death or urgent heart transplantation in the 5-year period of follow-up. The predictive power of VE/VCO2 slope and pVO2 were compared (area under the curve (AUC) analysis and Hanley & McNeil test), in the subgroups of patients with body mass index (BMI) of 18.5-24.9 kg/m2 and ≥ 25 kg/m2. Statistical differences with a p value < 0.05 were considered significant. RESULTS: There were 270 enrolled patients, with a mean BMI of 27 ± 4 kg/m2. No differences between normal and overweight patients (38.0% vs 29.8%, P=0.170) were found during the 5-year period for the primary endpoint. The VE/VCO2 slope was non-inferior to pVO2 in both groups at 1, 3 and 5 years of follow-up. The comparison of VE/VCO2 slope between groups revealed a significant lower AUC at 3 (0.921 vs 0.787, P=0.022) and 5 years (0.898 vs 0.787, P=0.044) of follow-up for overweight patients. CONCLUSION: Despite VE/VCO2 slope provides a discriminative power at least as good as pVO2 for predicting adverse events in both normal and overweight HFpatients, a significant lower predictive power was found in overweight patients. AJCD
Authors: Javed Butler; Ghazanfar Khadim; Kimberly M Paul; Stacy F Davis; Marvin W Kronenberg; Don B Chomsky; Richard N Pierson; John R Wilson Journal: J Am Coll Cardiol Date: 2004-03-03 Impact factor: 24.094
Authors: Mandeep R Mehra; Charles E Canter; Margaret M Hannan; Marc J Semigran; Patricia A Uber; David A Baran; Lara Danziger-Isakov; James K Kirklin; Richard Kirk; Sudhir S Kushwaha; Lars H Lund; Luciano Potena; Heather J Ross; David O Taylor; Erik A M Verschuuren; Andreas Zuckermann Journal: J Heart Lung Transplant Date: 2016-01 Impact factor: 10.247
Authors: Ugo Corrà; Pier Giuseppe Agostoni; Stefan D Anker; Andrew J S Coats; Maria G Crespo Leiro; Rudolph A de Boer; Veli-Pekka Harjola; Loreena Hill; Mitja Lainscak; Lars H Lund; Marco Metra; Piotr Ponikowski; Jillian Riley; Petar M Seferović; Massimo F Piepoli Journal: Eur J Heart Fail Date: 2017-09-18 Impact factor: 15.534
Authors: Tamara B Horwich; Eric S Leifer; Clinton A Brawner; Meredith B Fitz-Gerald; Gregg C Fonarow Journal: Am Heart J Date: 2009-10 Impact factor: 4.749