Exercise oscillatory breathing in diastolic heart failure: Prevalence and prognostic insights

Marco Guazzi, Jonathan Myers, Mary Ann Peberdy, Daniel Bensimhon, Paul Chase, Ross Arena

Research output: Contribution to journalArticlepeer-review


Aims: Exercise intolerance occurs in both systolic and diastolic heart failure (HF). Exercise oscillatory breathing (EOB) is a powerful predictor of survival in patients with systolic HF. In diastolic HF, EOB prevalence and prognostic impact are unknown. Methods and results: A total of 556 HF patients (405 with systolic HF and 151 with diastolic HF) underwent cardiopulmonary exercise testing (CPET). Diastolic HF was defined as signs and symptoms of HF, a left ventricular ejection fraction ≥50%, and a Doppler early (E) mitral to early mitral annulus ratio (E′) ≥8. CPET responses, EOB prevalence and its ability to predict cardiac-related events were examined. EOB prevalence in systolic and diastolic HF was similar (35 vs. 31%). Compared with the patients without EOB, patients with EOB and either systolic or diastolic HF had a higher New York Heart Association class, lower peak VO2 and higher E/E′ ratio (all P <0.01). Univariate Cox regression analysis demonstrated that peak VO2, VE/VCO2 slope and EOB all were significant predictors of cardiac events in both systolic and diastolic HF. Multivariable analysis revealed that EOB was retained as a prognostic marker in systolic HF and was the strongest predictor of cardiac events in diastolic HF. Conclusion: EOB occurrence is similar in diastolic and systolic HF and provides relevant clues for the identification of diastolic HF patients at increased risk of adverse events.

Original languageEnglish
Pages (from-to)2751-2759
Number of pages9
JournalEuropean Heart Journal
Issue number22
Publication statusPublished - Nov 2008


  • Diastolic heart failure
  • Exercise oscillatory breathing

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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