Aims: To evaluate the prognostic significance of traditional cardiopulmonary exercise testing (CPET) parameters in chronic heart failure (CHF) patients treated with beta-blockers.Methods and resultsA total of 631 CHF patients were followed for cardiovascular death over 3.8 ± 1.4 years; among them 79 (13) died. All prognostic CPET parameters were related to outcome at univariate analysis, with haemodynamic-derived parameters [peak systolic blood pressure (SBP), peak circulatory power (CP) = peak oxygen consumption (pVO2) × peak SBP] and exertional oscillatory ventilation (EOV) reaching the highest χ2 (46.5, 40.9, and 22.6, respectively, all with P <0.0001). Exertional oscillatory ventilation, although associated with high mortality rate (43 vs. 11, P <0.001), was detected in 42 (7) patients. In non-EOV, again both peak SBP and peak CP reached the highest χ2 (30.6, and 21.6, respectively, all with P <0.0001). Regarding CPET parameters, at multivariable analysis, peak SBP was the strongest risk index both in total and non-EOV populations, with 11 risk reduction every 5 mmHg increase.ConclusionAll traditional CPET risk parameters were informative in beta-blockers CHF patients, but peak SBP, peak CP, and EOV were the most predictive. In this low-risk population, EOV, although underrepresented, considerably enhanced risk stratification, although other ventilatory efficiency indexes provided less impressive predictive content. In large majority of non-EOV patients, peak SBP improved risk evaluation beyond other CPET parameters.
- Heart failure
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine