Abstract
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 language | English |
|---|---|
| Pages (from-to) | 2751-2759 |
| Number of pages | 9 |
| Journal | European Heart Journal |
| Volume | 29 |
| Issue number | 22 |
| DOIs | |
| Publication status | Published - Nov 2008 |
Fingerprint
Keywords
- Diastolic heart failure
- Exercise oscillatory breathing
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Exercise oscillatory breathing in diastolic heart failure : Prevalence and prognostic insights. / Guazzi, Marco; Myers, Jonathan; Peberdy, Mary Ann; Bensimhon, Daniel; Chase, Paul; Arena, Ross.
In: European Heart Journal, Vol. 29, No. 22, 11.2008, p. 2751-2759.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Exercise oscillatory breathing in diastolic heart failure
T2 - Prevalence and prognostic insights
AU - Guazzi, Marco
AU - Myers, Jonathan
AU - Peberdy, Mary Ann
AU - Bensimhon, Daniel
AU - Chase, Paul
AU - Arena, Ross
PY - 2008/11
Y1 - 2008/11
N2 - 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.
AB - 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.
KW - Diastolic heart failure
KW - Exercise oscillatory breathing
UR - http://www.scopus.com/inward/record.url?scp=56449126506&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=56449126506&partnerID=8YFLogxK
U2 - 10.1093/eurheartj/ehn437
DO - 10.1093/eurheartj/ehn437
M3 - Article
C2 - 18836201
AN - SCOPUS:56449126506
VL - 29
SP - 2751
EP - 2759
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 22
ER -