Combining the ventilatory response to exercise and peak oxygen consumption is no better than peak oxygen consumption alone in predicting mortality in chronic heart failure.
BACKGROUND
A low peak oxygen uptake (pVO(2)) and steep VE/VCO(2) slope are independently associated with a worse prognosis in patients with chronic heart failure (CHF). We wished to confirm whether combining these variables as a ratio would lead to a more accurate predictor of prognosis than using either alone.


METHODS
388 CHF patients completed a treadmill-based cardiopulmonary exercise test (CPET) to volitional exhaustion using a modified Bruce protocol.


RESULTS
212 CHF patients completed the CPET with a peak RER >or= 1.0. Of these, 48 patients died and one was transplanted during follow-up. In surviving patients, the median follow-up period was 42 months (IQR 34-49 months). The ratio VE/VCO(2) slope/pVO(2) was calculated for each individual and its ability to predict outcome compared with other variables. The Cox multivariable survival analysis showed that pVO(2) was the strongest independent predictor of mortality in CHF patients.


CONCLUSIONS
Our study shows that the composite variable VE/VCO(2) slope/pVO(2) is a less effective prognosticator than pVO(2) alone in patients with CHF.
Ingle
Lee
L
Carnegie Research Institute, Leeds Metropolitan University, Leeds, UK.
Witte
Klaus K
KK
Cleland
John G F
JG
Clark
Andrew L
AL
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000378:metabolism / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D008297:Male; D010101:Oxygen Consumption; D011379:Prognosis; D012119:Respiration; D015996:Survival Rate