Cardiopulmonary exercise testing and prognosis in heart failure due to systolic left ventricular dysfunction: A validation study of the European Society of Cardiology Guidelines and Recommendations (2008) and further developments

Ugo Corrà, Andrea Giordano, Alessandro Mezzani, Marco Gnemmi, Massimo Pistono, Roberto Caruso, Pantaleo Giannuzzi

Research output: Contribution to journalArticle

Abstract

Aims: The study aims were to validate the cardiopulmonary exercise testing (CPET) parameters recommended by the European Society of Cardiology 2008 Guidelines for risk assessment in heart failure (HF) (ESC-predictors) and to verify the predictive role of 11 supplementary CPET (S-predictors) parameters. Methods and results: We followed 749 HF patients for cardiovascular death and urgent heart transplantation for 3 years: 139 (19%) patients had cardiac events. ESC-predictors-peak oxygen consumption (VO 2), slope of minute ventilation vs carbon dioxide production (VE/VCO 2) and exertional oscillatory ventilation-were all related to outcome at univariate and multivariable analysis. The ESC/2008 prototype based on ESC-predictors presented a Harrell's C concordance index of 0.725, with a likely χ2 of 98.31. S-predictors-predicted peak VO 2, peak oxygen pulse, peak respiratory exchange ratio, peak circulatory power, peak VE/VCO 2, VE/VCO 2 slope normalized by peak VO 2, VO 2 efficiency slope, ventilatory anaerobic threshold detection, peak end-tidal CO 2 partial pressure, peak heart rate, and peak systolic arterial blood pressure (SBP)-were all linked to outcome at univariate analysis. When individually added to the ESC/2008 prototype, only peak SBP and peak O 2 pulse significantly improved the model discrimination ability: the ESC+peak SBP prototype had a Harrell's C index 0.750 and reached the highest likely χ2 (127.16, p

Original languageEnglish
Pages (from-to)32-40
Number of pages9
JournalEuropean Journal of Cardiovascular Prevention and Rehabilitation
Volume19
Issue number1
DOIs
Publication statusPublished - Feb 2012

Fingerprint

Validation Studies
Left Ventricular Dysfunction
Arterial Pressure
Heart Failure
Guidelines
Exercise
Ventilation
Anaerobic Threshold
Partial Pressure
Heart Transplantation
Carbon Monoxide
Carbon Dioxide
Oxygen Consumption
Heart Rate
Oxygen

Keywords

  • Exercise testing
  • Heart failure
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Epidemiology

Cite this

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abstract = "Aims: The study aims were to validate the cardiopulmonary exercise testing (CPET) parameters recommended by the European Society of Cardiology 2008 Guidelines for risk assessment in heart failure (HF) (ESC-predictors) and to verify the predictive role of 11 supplementary CPET (S-predictors) parameters. Methods and results: We followed 749 HF patients for cardiovascular death and urgent heart transplantation for 3 years: 139 (19{\%}) patients had cardiac events. ESC-predictors-peak oxygen consumption (VO 2), slope of minute ventilation vs carbon dioxide production (VE/VCO 2) and exertional oscillatory ventilation-were all related to outcome at univariate and multivariable analysis. The ESC/2008 prototype based on ESC-predictors presented a Harrell's C concordance index of 0.725, with a likely χ2 of 98.31. S-predictors-predicted peak VO 2, peak oxygen pulse, peak respiratory exchange ratio, peak circulatory power, peak VE/VCO 2, VE/VCO 2 slope normalized by peak VO 2, VO 2 efficiency slope, ventilatory anaerobic threshold detection, peak end-tidal CO 2 partial pressure, peak heart rate, and peak systolic arterial blood pressure (SBP)-were all linked to outcome at univariate analysis. When individually added to the ESC/2008 prototype, only peak SBP and peak O 2 pulse significantly improved the model discrimination ability: the ESC+peak SBP prototype had a Harrell's C index 0.750 and reached the highest likely χ2 (127.16, p",
keywords = "Exercise testing, Heart failure, Prognosis",
author = "Ugo Corr{\`a} and Andrea Giordano and Alessandro Mezzani and Marco Gnemmi and Massimo Pistono and Roberto Caruso and Pantaleo Giannuzzi",
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T2 - A validation study of the European Society of Cardiology Guidelines and Recommendations (2008) and further developments

AU - Corrà, Ugo

AU - Giordano, Andrea

AU - Mezzani, Alessandro

AU - Gnemmi, Marco

AU - Pistono, Massimo

AU - Caruso, Roberto

AU - Giannuzzi, Pantaleo

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