Exercise Oscillatory Ventilation May Predict Sudden Cardiac Death in Heart Failure Patients

Marco Guazzi, Rosa Raimondo, Marco Vicenzi, Ross Arena, Chiara Proserpio, Simona Sarzi Braga, Roberto Pedretti

Research output: Contribution to journalArticle

Abstract

Objectives: The purpose of this study was to test the ability of cardiopulmonary exercise testing (CPET)-derived variables as sudden cardiac death (SCD) predictors. Background: The CPET variables, such as peak oxygen uptake (VO2), ventilatory requirement to carbon dioxide (CO2) production (VE/VCO2) slope, and exercise oscillatory breathing (EOB), are strong predictors of overall mortality in chronic heart failure (CHF) patients. Even though up to 50% of CHF patients die from SCD, it is unknown whether any of these variables predicts SCD. Methods: One hundred fifty-six CHF patients (mean age: 60.9 ± 9.4 years; mean ejection fraction: 34.9 ± 10.6%) underwent CPET. Subjects were tracked for sudden versus pump-failure cardiac mortality over 27.8 ± 25.2 months. Results: Seventeen patients died from SCD, and 17 died from cardiac pump failure. Survivors showed significantly higher peak VO2 (16.8 ± 4.5 ml·kg-1·min-1) and lower VE/VCO2 slope (32.8 ± 6.4) and prevalence of EOB (20.3%), compared with subjects who experienced arrhythmic (13.5 ± 3.2 ml·kg-1·min-1; 41.5 ± 11.4; 100%) or nonarrhythmic (14.1 ± 4.7 ml·kg-1·min-1; 38.1 ± 7.3; 47.1%) deaths (p <0.05). At Cox regression analysis, all variables were significant univariate predictors of both sudden and pump failure death (p <0.01). Multivariate analysis, including left ventricular (LV) ejection fraction, LV end systolic volume, and LV mass selected EOB, was the strongest predictor of both overall mortality (chi-square: 38.7, p <0.001) and SCD (chi-square: 44.7, p <0.001), whereas VE/VCO2 slope was the strongest ventilatory predictor of pump failure death (chi-square: 11.8, p = 0.001). Conclusions: Exercise oscillatory breathing is an independent predictor of SCD in patients with CHF and might help as an additional marker for prioritization of antiarrhythmic strategies.

Original languageEnglish
Pages (from-to)299-308
Number of pages10
JournalJournal of the American College of Cardiology
Volume50
Issue number4
DOIs
Publication statusPublished - Jul 24 2007

Fingerprint

Sudden Cardiac Death
Breathing Exercises
Ventilation
Heart Failure
Exercise
Stroke Volume
Mortality
Exercise Test
Carbon Dioxide
Survivors
Multivariate Analysis
Regression Analysis
Oxygen

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Exercise Oscillatory Ventilation May Predict Sudden Cardiac Death in Heart Failure Patients. / Guazzi, Marco; Raimondo, Rosa; Vicenzi, Marco; Arena, Ross; Proserpio, Chiara; Sarzi Braga, Simona; Pedretti, Roberto.

In: Journal of the American College of Cardiology, Vol. 50, No. 4, 24.07.2007, p. 299-308.

Research output: Contribution to journalArticle

@article{2612beb838ff4cee90fb7ef0f6cf0699,
title = "Exercise Oscillatory Ventilation May Predict Sudden Cardiac Death in Heart Failure Patients",
abstract = "Objectives: The purpose of this study was to test the ability of cardiopulmonary exercise testing (CPET)-derived variables as sudden cardiac death (SCD) predictors. Background: The CPET variables, such as peak oxygen uptake (VO2), ventilatory requirement to carbon dioxide (CO2) production (VE/VCO2) slope, and exercise oscillatory breathing (EOB), are strong predictors of overall mortality in chronic heart failure (CHF) patients. Even though up to 50{\%} of CHF patients die from SCD, it is unknown whether any of these variables predicts SCD. Methods: One hundred fifty-six CHF patients (mean age: 60.9 ± 9.4 years; mean ejection fraction: 34.9 ± 10.6{\%}) underwent CPET. Subjects were tracked for sudden versus pump-failure cardiac mortality over 27.8 ± 25.2 months. Results: Seventeen patients died from SCD, and 17 died from cardiac pump failure. Survivors showed significantly higher peak VO2 (16.8 ± 4.5 ml·kg-1·min-1) and lower VE/VCO2 slope (32.8 ± 6.4) and prevalence of EOB (20.3{\%}), compared with subjects who experienced arrhythmic (13.5 ± 3.2 ml·kg-1·min-1; 41.5 ± 11.4; 100{\%}) or nonarrhythmic (14.1 ± 4.7 ml·kg-1·min-1; 38.1 ± 7.3; 47.1{\%}) deaths (p <0.05). At Cox regression analysis, all variables were significant univariate predictors of both sudden and pump failure death (p <0.01). Multivariate analysis, including left ventricular (LV) ejection fraction, LV end systolic volume, and LV mass selected EOB, was the strongest predictor of both overall mortality (chi-square: 38.7, p <0.001) and SCD (chi-square: 44.7, p <0.001), whereas VE/VCO2 slope was the strongest ventilatory predictor of pump failure death (chi-square: 11.8, p = 0.001). Conclusions: Exercise oscillatory breathing is an independent predictor of SCD in patients with CHF and might help as an additional marker for prioritization of antiarrhythmic strategies.",
author = "Marco Guazzi and Rosa Raimondo and Marco Vicenzi and Ross Arena and Chiara Proserpio and {Sarzi Braga}, Simona and Roberto Pedretti",
year = "2007",
month = "7",
day = "24",
doi = "10.1016/j.jacc.2007.03.042",
language = "English",
volume = "50",
pages = "299--308",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "4",

}

TY - JOUR

T1 - Exercise Oscillatory Ventilation May Predict Sudden Cardiac Death in Heart Failure Patients

AU - Guazzi, Marco

AU - Raimondo, Rosa

AU - Vicenzi, Marco

AU - Arena, Ross

AU - Proserpio, Chiara

AU - Sarzi Braga, Simona

AU - Pedretti, Roberto

PY - 2007/7/24

Y1 - 2007/7/24

N2 - Objectives: The purpose of this study was to test the ability of cardiopulmonary exercise testing (CPET)-derived variables as sudden cardiac death (SCD) predictors. Background: The CPET variables, such as peak oxygen uptake (VO2), ventilatory requirement to carbon dioxide (CO2) production (VE/VCO2) slope, and exercise oscillatory breathing (EOB), are strong predictors of overall mortality in chronic heart failure (CHF) patients. Even though up to 50% of CHF patients die from SCD, it is unknown whether any of these variables predicts SCD. Methods: One hundred fifty-six CHF patients (mean age: 60.9 ± 9.4 years; mean ejection fraction: 34.9 ± 10.6%) underwent CPET. Subjects were tracked for sudden versus pump-failure cardiac mortality over 27.8 ± 25.2 months. Results: Seventeen patients died from SCD, and 17 died from cardiac pump failure. Survivors showed significantly higher peak VO2 (16.8 ± 4.5 ml·kg-1·min-1) and lower VE/VCO2 slope (32.8 ± 6.4) and prevalence of EOB (20.3%), compared with subjects who experienced arrhythmic (13.5 ± 3.2 ml·kg-1·min-1; 41.5 ± 11.4; 100%) or nonarrhythmic (14.1 ± 4.7 ml·kg-1·min-1; 38.1 ± 7.3; 47.1%) deaths (p <0.05). At Cox regression analysis, all variables were significant univariate predictors of both sudden and pump failure death (p <0.01). Multivariate analysis, including left ventricular (LV) ejection fraction, LV end systolic volume, and LV mass selected EOB, was the strongest predictor of both overall mortality (chi-square: 38.7, p <0.001) and SCD (chi-square: 44.7, p <0.001), whereas VE/VCO2 slope was the strongest ventilatory predictor of pump failure death (chi-square: 11.8, p = 0.001). Conclusions: Exercise oscillatory breathing is an independent predictor of SCD in patients with CHF and might help as an additional marker for prioritization of antiarrhythmic strategies.

AB - Objectives: The purpose of this study was to test the ability of cardiopulmonary exercise testing (CPET)-derived variables as sudden cardiac death (SCD) predictors. Background: The CPET variables, such as peak oxygen uptake (VO2), ventilatory requirement to carbon dioxide (CO2) production (VE/VCO2) slope, and exercise oscillatory breathing (EOB), are strong predictors of overall mortality in chronic heart failure (CHF) patients. Even though up to 50% of CHF patients die from SCD, it is unknown whether any of these variables predicts SCD. Methods: One hundred fifty-six CHF patients (mean age: 60.9 ± 9.4 years; mean ejection fraction: 34.9 ± 10.6%) underwent CPET. Subjects were tracked for sudden versus pump-failure cardiac mortality over 27.8 ± 25.2 months. Results: Seventeen patients died from SCD, and 17 died from cardiac pump failure. Survivors showed significantly higher peak VO2 (16.8 ± 4.5 ml·kg-1·min-1) and lower VE/VCO2 slope (32.8 ± 6.4) and prevalence of EOB (20.3%), compared with subjects who experienced arrhythmic (13.5 ± 3.2 ml·kg-1·min-1; 41.5 ± 11.4; 100%) or nonarrhythmic (14.1 ± 4.7 ml·kg-1·min-1; 38.1 ± 7.3; 47.1%) deaths (p <0.05). At Cox regression analysis, all variables were significant univariate predictors of both sudden and pump failure death (p <0.01). Multivariate analysis, including left ventricular (LV) ejection fraction, LV end systolic volume, and LV mass selected EOB, was the strongest predictor of both overall mortality (chi-square: 38.7, p <0.001) and SCD (chi-square: 44.7, p <0.001), whereas VE/VCO2 slope was the strongest ventilatory predictor of pump failure death (chi-square: 11.8, p = 0.001). Conclusions: Exercise oscillatory breathing is an independent predictor of SCD in patients with CHF and might help as an additional marker for prioritization of antiarrhythmic strategies.

UR - http://www.scopus.com/inward/record.url?scp=34447311088&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34447311088&partnerID=8YFLogxK

U2 - 10.1016/j.jacc.2007.03.042

DO - 10.1016/j.jacc.2007.03.042

M3 - Article

C2 - 17659196

AN - SCOPUS:34447311088

VL - 50

SP - 299

EP - 308

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 4

ER -