title: Combining ventilatory efficiency and peak oxygen consumption in the prognostic assessment of patients with chronic heart failure.
abstract: Cardiopulmonary exercise testing (CPET) is an objective method for assessment of functional capacity and for prognostic stratification of patients with chronic heart failure (CHF). In this study, we analyzed the prognostic value of a recently described CPET-derived parameter, the minute ventilation to carbon dioxide production slope normalized for peak oxygen consumption (VE/VCO2 slope/pVO2).
  
  
  METHODS
  We prospectively studied 157 patients with stable CHF and dilated cardiomyopathy who performed maximal CPET using the modified Bruce protocol. The prognostic value of VE/VCO2 slope/pVO2 was determined and compared with traditional CPET parameters.
  
  
  RESULTS
  During follow-up 37 patients died and 12 were transplanted. Mean follow-up in surviving patients was 29.7 months (12-36). Cox multivariate analysis revealed that VE/VCO2 slope/pVO2 had the greatest prognostic power of all the parameters studied. A VE/VCO2 slope/pVO2 of > or = 2.2 signaled cases at higher risk.
  
  
  CONCLUSIONS
  Normalization of the ventilatory response to exercise for peak oxygen consumption appears to increase the prognostic value of CPET in patients with CHF.
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Maria, Lisboa, Portugal. alexandra_toste@hotmail.com
authors.forename: Alexandra
authors.initials: A
authors.lastname: Toste
authors.forename: Rui M
authors.initials: RM
authors.lastname: Soares
authors.forename: Joana
authors.initials: J
authors.lastname: Feliciano
authors.forename: Valeska
authors.initials: V
authors.lastname: Andreozzi
authors.forename: Sofia
authors.initials: S
authors.lastname: Silva
authors.forename: Sandra
authors.initials: S
authors.lastname: Alves
authors.forename: Lurdes
authors.initials: L
authors.lastname: Ferreira
authors.forename: Ana
authors.initials: A
authors.lastname: Abreu
authors.forename: Rui Cruz
authors.initials: RC
authors.lastname: Ferreira
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011379:Prognosis; D011446:Prospective Studies; D055815:Young Adult