Isocapnic buffering period

From physiology to clinics

Cosimo Carriere, Ugo Corrà, Massimo Piepoli, Alice Bonomi, Elisabetta Salvioni, Simone Binno, Alessandra Magini, Susanna Sciomer, Beatrice Pezzuto, Piero Gentile, Mauro Schina, Gianfranco Sinagra, Piergiuseppe Agostoni

Research output: Contribution to journalArticle

Abstract

BACKGROUND: During cardiopulmonary exercise test, the isocapnic buffering period ranges between anaerobic threshold (AT) and respiratory compensation point (RCP). We investigated whether oxygen uptake (VO2) increase during the isocapnic buffering period (ΔVO2AT-RCP) is related to heart failure severity and prognosis.

METHODS: We retrospectively analysed reduced ejection fraction heart failure patients who attained RCP at cardiopulmonary exercise test. The study endpoint was the composite of cardiovascular mortality and urgent heart transplantation/left ventricular assist device implantation. Hazard ratio was assessed to identify the increase of risk associated with ΔVO2AT-RCP (below and above the median of ΔVO2AT-RCP).

RESULTS: AT and RCP were both identified in 782 (39.2%) out of 1995 reduced ejection fraction heart failure cases. Left ventricular ejection fraction and peak VO2 were 33 ± 9% and 16.5 ± 4.5 mL/kg per min (61 ± 16% of predicted value), suggesting moderate heart failure. At five years, endpoint did not vary between patients below and above the median ΔVO2AT-RCP (3.85 mL/min per kg (25-75th interquartile range = 2.69-5.46)). ΔVO2AT-RCP correlated with several parameters associated to heart failure prognosis, such as peak VO2, VE/VCO2 slope, brain natriuretic peptide and left ventricular ejection fraction. The ΔVO2AT-RCP value was associated with prognosis at univariate but not at multivariable analysis, where only VE/VCO2 slope endured.

CONCLUSION: ΔVO2AT-RCP correlates with several parameters linked to heart failure severity. Isocapnic buffering period stratifies heart failure patients, but not more than other prognostic indices.

Original languageEnglish
Pages (from-to)1107-1114
Number of pages8
JournalEuropean Journal of Preventive Cardiology
Volume26
Issue number10
DOIs
Publication statusPublished - Jul 2019

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Heart Failure
Anaerobic Threshold
Exercise Test
Stroke Volume
Heart-Assist Devices
Brain Natriuretic Peptide
Heart Transplantation
Oxygen
Mortality

Cite this

Isocapnic buffering period : From physiology to clinics. / Carriere, Cosimo; Corrà, Ugo; Piepoli, Massimo; Bonomi, Alice; Salvioni, Elisabetta; Binno, Simone; Magini, Alessandra; Sciomer, Susanna; Pezzuto, Beatrice; Gentile, Piero; Schina, Mauro; Sinagra, Gianfranco; Agostoni, Piergiuseppe.

In: European Journal of Preventive Cardiology, Vol. 26, No. 10, 07.2019, p. 1107-1114.

Research output: Contribution to journalArticle

Carriere, Cosimo ; Corrà, Ugo ; Piepoli, Massimo ; Bonomi, Alice ; Salvioni, Elisabetta ; Binno, Simone ; Magini, Alessandra ; Sciomer, Susanna ; Pezzuto, Beatrice ; Gentile, Piero ; Schina, Mauro ; Sinagra, Gianfranco ; Agostoni, Piergiuseppe. / Isocapnic buffering period : From physiology to clinics. In: European Journal of Preventive Cardiology. 2019 ; Vol. 26, No. 10. pp. 1107-1114.
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abstract = "BACKGROUND: During cardiopulmonary exercise test, the isocapnic buffering period ranges between anaerobic threshold (AT) and respiratory compensation point (RCP). We investigated whether oxygen uptake (VO2) increase during the isocapnic buffering period (ΔVO2AT-RCP) is related to heart failure severity and prognosis.METHODS: We retrospectively analysed reduced ejection fraction heart failure patients who attained RCP at cardiopulmonary exercise test. The study endpoint was the composite of cardiovascular mortality and urgent heart transplantation/left ventricular assist device implantation. Hazard ratio was assessed to identify the increase of risk associated with ΔVO2AT-RCP (below and above the median of ΔVO2AT-RCP).RESULTS: AT and RCP were both identified in 782 (39.2{\%}) out of 1995 reduced ejection fraction heart failure cases. Left ventricular ejection fraction and peak VO2 were 33 ± 9{\%} and 16.5 ± 4.5 mL/kg per min (61 ± 16{\%} of predicted value), suggesting moderate heart failure. At five years, endpoint did not vary between patients below and above the median ΔVO2AT-RCP (3.85 mL/min per kg (25-75th interquartile range = 2.69-5.46)). ΔVO2AT-RCP correlated with several parameters associated to heart failure prognosis, such as peak VO2, VE/VCO2 slope, brain natriuretic peptide and left ventricular ejection fraction. The ΔVO2AT-RCP value was associated with prognosis at univariate but not at multivariable analysis, where only VE/VCO2 slope endured.CONCLUSION: ΔVO2AT-RCP correlates with several parameters linked to heart failure severity. Isocapnic buffering period stratifies heart failure patients, but not more than other prognostic indices.",
author = "Cosimo Carriere and Ugo Corr{\`a} and Massimo Piepoli and Alice Bonomi and Elisabetta Salvioni and Simone Binno and Alessandra Magini and Susanna Sciomer and Beatrice Pezzuto and Piero Gentile and Mauro Schina and Gianfranco Sinagra and Piergiuseppe Agostoni",
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TY - JOUR

T1 - Isocapnic buffering period

T2 - From physiology to clinics

AU - Carriere, Cosimo

AU - Corrà, Ugo

AU - Piepoli, Massimo

AU - Bonomi, Alice

AU - Salvioni, Elisabetta

AU - Binno, Simone

AU - Magini, Alessandra

AU - Sciomer, Susanna

AU - Pezzuto, Beatrice

AU - Gentile, Piero

AU - Schina, Mauro

AU - Sinagra, Gianfranco

AU - Agostoni, Piergiuseppe

PY - 2019/7

Y1 - 2019/7

N2 - BACKGROUND: During cardiopulmonary exercise test, the isocapnic buffering period ranges between anaerobic threshold (AT) and respiratory compensation point (RCP). We investigated whether oxygen uptake (VO2) increase during the isocapnic buffering period (ΔVO2AT-RCP) is related to heart failure severity and prognosis.METHODS: We retrospectively analysed reduced ejection fraction heart failure patients who attained RCP at cardiopulmonary exercise test. The study endpoint was the composite of cardiovascular mortality and urgent heart transplantation/left ventricular assist device implantation. Hazard ratio was assessed to identify the increase of risk associated with ΔVO2AT-RCP (below and above the median of ΔVO2AT-RCP).RESULTS: AT and RCP were both identified in 782 (39.2%) out of 1995 reduced ejection fraction heart failure cases. Left ventricular ejection fraction and peak VO2 were 33 ± 9% and 16.5 ± 4.5 mL/kg per min (61 ± 16% of predicted value), suggesting moderate heart failure. At five years, endpoint did not vary between patients below and above the median ΔVO2AT-RCP (3.85 mL/min per kg (25-75th interquartile range = 2.69-5.46)). ΔVO2AT-RCP correlated with several parameters associated to heart failure prognosis, such as peak VO2, VE/VCO2 slope, brain natriuretic peptide and left ventricular ejection fraction. The ΔVO2AT-RCP value was associated with prognosis at univariate but not at multivariable analysis, where only VE/VCO2 slope endured.CONCLUSION: ΔVO2AT-RCP correlates with several parameters linked to heart failure severity. Isocapnic buffering period stratifies heart failure patients, but not more than other prognostic indices.

AB - BACKGROUND: During cardiopulmonary exercise test, the isocapnic buffering period ranges between anaerobic threshold (AT) and respiratory compensation point (RCP). We investigated whether oxygen uptake (VO2) increase during the isocapnic buffering period (ΔVO2AT-RCP) is related to heart failure severity and prognosis.METHODS: We retrospectively analysed reduced ejection fraction heart failure patients who attained RCP at cardiopulmonary exercise test. The study endpoint was the composite of cardiovascular mortality and urgent heart transplantation/left ventricular assist device implantation. Hazard ratio was assessed to identify the increase of risk associated with ΔVO2AT-RCP (below and above the median of ΔVO2AT-RCP).RESULTS: AT and RCP were both identified in 782 (39.2%) out of 1995 reduced ejection fraction heart failure cases. Left ventricular ejection fraction and peak VO2 were 33 ± 9% and 16.5 ± 4.5 mL/kg per min (61 ± 16% of predicted value), suggesting moderate heart failure. At five years, endpoint did not vary between patients below and above the median ΔVO2AT-RCP (3.85 mL/min per kg (25-75th interquartile range = 2.69-5.46)). ΔVO2AT-RCP correlated with several parameters associated to heart failure prognosis, such as peak VO2, VE/VCO2 slope, brain natriuretic peptide and left ventricular ejection fraction. The ΔVO2AT-RCP value was associated with prognosis at univariate but not at multivariable analysis, where only VE/VCO2 slope endured.CONCLUSION: ΔVO2AT-RCP correlates with several parameters linked to heart failure severity. Isocapnic buffering period stratifies heart failure patients, but not more than other prognostic indices.

U2 - 10.1177/2047487319829950

DO - 10.1177/2047487319829950

M3 - Article

VL - 26

SP - 1107

EP - 1114

JO - European Journal of Preventive Cardiology

JF - European Journal of Preventive Cardiology

SN - 2047-4873

IS - 10

ER -