title: VE/VCO2 slope and oxygen uptake efficiency slope in patients with coronary artery disease and intermediate peakVO2.
abstract: BACKGROUND
  Peak exercise oxygen uptake (peakVO2) is a widely used prognosticator. Novel spirometric parameters, less affected by submaximal performance, such as the rate of increase of minute ventilation per unit decrease of carbon dioxide production (VE/VCO2 slope) and the oxygen uptake efficiency slope (OUES) have recently been introduced.
  
  
  OBJECTIVE
  To evaluate the discriminative value of OUES, as compared to VE/VCO2 slope in patients with coronary artery disease (CAD) and intermediate peakVO2 values.
  
  
  RESULTS
  Bicycle spiroergometry was applied in 214 patients with CAD (age 67+/-8 years, 85% men). OUES was strongly related to peakVO2 (r=0.79). New York Heart Association (NYHA) class, 6-min walking distance, N-terminal pro-brain natriuretic peptide (NT-proBNP), inflammatory markers, left ventricular (LV) volumes and ejection fraction were evaluated. NT-proBNP levels predicted independently VE/VCO2-slope and OUES. Patients with intermediate peakVO2 (12-18 ml/kg per min) and increased VE/VCO2-slope (> or = 35) had higher NYHA class, lower walking distance, higher NT-proBNP levels and higher LV volumes as compared to patients with a similar peakVO2 but lower VE/VCO2-slope. Similar findings were found for patients with intermediate peakVO2 and high OUES/kg (median value>15.3).
  
  
  CONCLUSIONS
  In CAD patients, OUES was strongly correlated with peakVO2. Both VE/VCO2 slope and OUES were independently associated with NT-proBNP levels. Both VE/VCO2 slope and OUES/kg were able to identify a subgroup of patients with an intermediate peakVO2 that was characterized by advanced remodelling and a higher degree of neurohumoral activation.
authors.affiliation: Department of Cardiology, Ghent University, Gent, Belgium. nico.vandeveire@ugent.be
authors.forename: Nico R
authors.initials: NR
authors.lastname: Van de Veire
authors.forename: Christophe
authors.initials: C
authors.lastname: Van Laethem
authors.forename: Jan
authors.initials: J
authors.lastname: Philippé
authors.forename: Olivier
authors.initials: O
authors.lastname: De Winter
authors.forename: Guy
authors.initials: G
authors.lastname: De Backer
authors.forename: Marc
authors.initials: M
authors.lastname: Vanderheyden
authors.forename: Johan
authors.initials: J
authors.lastname: De Sutter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D002245:Carbon Dioxide / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000503:physiopathology; D004797:Enzyme-Linked Immunosorbent Assay; D016552:Ergometry; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology*; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D015415:Biomarkers; D002245:Carbon Dioxide