[Prognostic value of results from clinical tests, echocardiographic, electrocardiographic and spiro-ergometric exercise test examinations in patients with heart failure].
The aim of this study was to assess the importance of the non invasive procedures in determinating prognosis of patients with heart failure (HF).


METHODS
We investigated 110 patients with a mean age of 52.1 (65 patients--59%) with chronic (HF) due to coronary artery diseases and dilated cardiomyopathy (45 patients--41%). All the patients underwent baseline evaluations including a clinical status, echocardiography, Holter monitoring and a cardiopulmonary exercise test (CPX). After the mean follow-up period of 28.5 +/- 12 months, the patients were divided into 2 groups: Group I--in which 78 patients survived without heart transplantation (HTX) and Group II--in which 20 patients died and 12 underwent HTX. The relationship between the variables derived from noninvasive procedures was assessed using multivariate Cox proportional hazards models.


RESULTS
Compared to group I, Group II had a significantly higher number of patients that were classified into NYHA class III. In addition, a third heart tone was identified more often in group II and an increased number of HF etiology was due to ischemia. Electrocardiographic recording showed an increased frequency of left bundle branch block and complex ventricular arrythmias. Markedly increased values of WSLK, OKSLK, WLP, OKRLK and FW were found in group II, as compared to group I. Cardiopulmonary exercise tests in group II revealed lower values of T, VO2AT, SBPpeak, VO2peak, VO2peak%N, PETCO2peak as well as VD/VTpeak, VE/VO2peak, and VE/VCO2peak. After multivariate analysis lope VE/VCO2peak (p = 0.009), peak oxygen uptake VO2peak-%N (p = 0.035), (p = 0.036), left ventricle end systolic volume (p = 0.045) and left bundle branch block (p = 0.046) were independent predictors of survival without heart transplantation.


CONCLUSIONS
On multivariate analysis by the Cox proportional hazards method, the variables: VE/VCO2peak, VO2peak%N, etiology--CAD, OKSLK, and left bundle branch block were independent prognostic predictors. The echocardio-graphic evaluation play a significant role in the assessment of prognosis in patients, with HF. The ejection fraction of the left ventricle was not confirmed as an independent prognostic factor in HF.
Tomkiewicz-Pajak
Lidia
L
Klinika Chorób Serca i Naczyń Instytut Kardiologii Collegium Medicum Uniwersytetu Jagiellońskiego, 31-202 Kraków, ul. Pradnicka 80.
Podolec
Piotr
P
Kostkiewicz
Magdalena
M
Tracz
Wiesława
W
Suchoń
Elzbieta
E
Krochin
Marek
M
D000328:Adult; D000368:Aged; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis*; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010101:Oxygen Consumption; D011379:Prognosis; D016016:Proportional Hazards Models