Background: Chronic heart failure carries a poor prognosis. Cardiopulmonary exercise testing is useful in predicting survival. We set out to establish the prognostic value of peak VO2 and VE/VCO2 slope across a range of threshold values. Method and Results: Three hundred and three consecutive patients with stable chronic heart failure underwent cardiopulmonary exercise testing between 1992 and 1996. Their age was 59 ± 11 years (mean ± SD), peak VO2 17.8 ± 6.6 ml.kg-1 min-1, VE/VCO2 slope 37 ± 12. At the end of follow-up in January 1999, 91 patients had died (after a median of 7 months, interquartile range 3-16 months). The median follow-up for the survivors was 47 months (interquartile range 37-57 months). The areas under the receiver-operating characteristic curves for predicting mortality at 2 years were 0.77 for both peak VO2 and VE/VCO2 slope. With peak VO2 and VE/VCO2 slope viewed as continuous variables in the Cox proportional-hazards model, they were both highly significant prognostic indicators, both in univariate analysis and bivariate analysis (P <0.001 for VE/VCO2 slope, P <0.003 for peak VO2). Conclusions: Lower peak VO2 implies poorer prognosis across a range of values from 10 to 20 ml.kg-1 min-1 without a unique threshold. Gradations of elevation of the VE/VCO2, slope also carry prognostic information over a wide range (30-55). The two parameters are comparable in terms of prognostic power, and contribute complementary prognostic information. (C) 2000 The European Society of Cardiology.
|Number of pages||8|
|Journal||European Heart Journal|
|Publication status||Published - Jan 15 2000|
- Cardiopulmonary exercise testing
- Chronic heart failure
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine