title: VE/VCO2slope and its prognostic value in patients with chronic heart failure.
abstract: The minute ventilation/carbon dioxide production (VE/VCO2) slope has been widely demonstrated to have strong prognostic value in patients with chronic heart failure (CHF), and the risk of mortality is believed to increase when the VE/VCO2slope is >32.8; however, there is little evidence concerning the prognostic value of the VE/VCO2slope in Chinese patients. In the present study, the prognostic value of the VE/VCO2slope was investigated in patients with CHF. A total of 258 subjects underwent symptom-limited cardiopulmonary exercise testing (CPET) and were divided into CHF (113 males and 16 females; LVEF <0.49) and control (106 males and 23 females) groups. The cardiac-related events over a median 33.7-month follow-up period subsequent to the CPET were evaluated using receiver operating characteristic curve analysis. The VE/VCO2slope was significantly different between the CHF and control groups (P<0.001). The area under the curve (AUC) for the VE/VCO2slope in predicting cardiac-related mortalities in the patients with CHF was 0.670 (P<0.05), and the sensitivity and specificity of the VE/VCO2slope were 0.667 and 0.620, respectively. The optimal threshold of the VE/VCO2slope for predicting cardiac-related mortalities in patients with CHF was ≥39.3. The AUC for the VE/VCO2slope in predicting cardiac-related hospitalizations in patients with CHF was 0.682 (P<0.05), and the sensitivity and specificity of the VE/VCO2slope were 0.631 and 0.778, respectively. The optimal threshold of the VE/VCO2slope for predicting cardiac-related hospitalizations in patients with CHF was ≥32.9. In conclusion, ventilatory efficiency decreases in patients with CHF. The VE/VCO2slope is a strong predictor of cardiac-related mortalities in the patients with CHF analyzed.
authors.affiliation: Department of Cardiology, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, P.R. China.
authors.forename: Yuqin
authors.initials: Y
authors.lastname: Shen
authors.affiliation: Department of Rheumatology, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, P.R. China.
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, P.R. China.
authors.forename: Wenlin
authors.initials: W
authors.lastname: Ma
authors.affiliation: Department of Cardiology, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, P.R. China.
authors.forename: Haoming
authors.initials: H
authors.lastname: Song
authors.affiliation: Department of Cardiology, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, P.R. China.
authors.forename: Zhu
authors.initials: Z
authors.lastname: Gong
authors.affiliation: Department of Cardiology, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, P.R. China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, P.R. China.
authors.forename: Lin
authors.initials: L
authors.lastname: Che
authors.affiliation: Department of Cardiology, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, P.R. China.
authors.forename: Wenjun
authors.initials: W
authors.lastname: Xu
authors.affiliation: Department of Cardiology, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, P.R. China.
authors.forename: Jinfa
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Department of Cardiology, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, P.R. China.
authors.forename: Jiahong
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Cardiology, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, P.R. China.
authors.forename: Wenwen
authors.initials: W
authors.lastname: Yan
authors.affiliation: Department of Cardiology, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, P.R. China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Department of Cardiology, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, P.R. China.
authors.forename: Y I
authors.initials: YI
authors.lastname: Ni
authors.affiliation: Department of Cardiology, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, P.R. China.
authors.forename: Guanghe
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Cardiology, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, P.R. China.
authors.forename: Qiping
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, P.R. China.
authors.forename: Lemin
authors.initials: L
authors.lastname: Wang
keywords: cardiopulmonary exercise test; heart failure; ventilatory expired gas