Abstract
Aims: The influence of permanent atrial fibrillation on exercise tolerance and cardio-respiratory function during exercise in heart failure (HF) is unknown. Methods and results: We retrospectively compared the results of 942 cardiopulmonary exercise tests, performed consecutively at seven Italian laboratories, in HF patients with atrial fibrillation (n = 180) and sinus rhythm (n = 762). By multivariable logistic regression analysis, peak VO2 (OR 0.376, 95% CI 0.240-0.588, P <0.0001), O2pulse (VO 2/heart rate, HR) (OR 0.236, 95% CI 0.152-0.366, P <0.0001), VCO2 (OR 3.97, 95% CI 2.163-7.287, P <0.0001), and ventilation (OR 1.38, 95% CI 1.045-1.821, P = 0.0231) were independently associated with atrial fibrillation. Anaerobic threshold (AT) was identified in 132 of 180 (73%) atrial fibrillation and in 649 of 762 (85%) sinus rhythm patients (P = 0.0002). By multivariable logistic regression analysis, only peak VO2 (OR 0.214, 95% CI 0.155-0.296, P <0.0001) was independently associated with unidentified AT. At AT, atrial fibrillation HF patients had higher HR (P <0.0001) and higher VO2 (P <0.001) compared with sinus rhythm HF patients. Among AT variables, by multivariable logistic regression analysis, only HR was an independent predictor of atrial fibrillation. Conclusion: In HF patients with permanent atrial fibrillation, exercise performance is reduced as reflected by reduced peak VO2. The finding of unidentified AT is associated with a poor performance. In atrial fibrillation patients, VO 2 is higher at AT whereas lower at peak. This last observation raises uncertainties about the use of AT data to define performance and prognosis of HF patients with atrial fibrillation.
| Original language | English |
|---|---|
| Pages (from-to) | 2367-2372 |
| Number of pages | 6 |
| Journal | European Heart Journal |
| Volume | 29 |
| Issue number | 19 |
| DOIs | |
| Publication status | Published - Oct 2008 |
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Keywords
- Anaerobic threshold
- Atrial fibrillation
- Cardiopulmonary exercise testing
- Heart failure
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Permanent atrial fibrillation affects exercise capacity in chronic heart failure patients. / Agostoni, Piergiuseppe; Emdin, Michele; Corrà, Ugo; Veglia, Fabrizio; Magrì, Damiano; Tedesco, Calogero C.; Berton, Emanuela; Passino, Claudio; Bertella, Erika; Re, Federica; Mezzani, Alessandro; Belardinelli, Romualdo; Colombo, Chiara; La Gioia, Rocco; Vicenzi, Marco; Giannoni, Alberto; Scrutinio, Domenico; Giannuzzi, Pantaleo; Tondo, Claudio; Di Lenarda, Andrea; Sinagra, Gianfranco; Piepoli, Massimo F.; Guazzi, Marco.
In: European Heart Journal, Vol. 29, No. 19, 10.2008, p. 2367-2372.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Permanent atrial fibrillation affects exercise capacity in chronic heart failure patients
AU - Agostoni, Piergiuseppe
AU - Emdin, Michele
AU - Corrà, Ugo
AU - Veglia, Fabrizio
AU - Magrì, Damiano
AU - Tedesco, Calogero C.
AU - Berton, Emanuela
AU - Passino, Claudio
AU - Bertella, Erika
AU - Re, Federica
AU - Mezzani, Alessandro
AU - Belardinelli, Romualdo
AU - Colombo, Chiara
AU - La Gioia, Rocco
AU - Vicenzi, Marco
AU - Giannoni, Alberto
AU - Scrutinio, Domenico
AU - Giannuzzi, Pantaleo
AU - Tondo, Claudio
AU - Di Lenarda, Andrea
AU - Sinagra, Gianfranco
AU - Piepoli, Massimo F.
AU - Guazzi, Marco
PY - 2008/10
Y1 - 2008/10
N2 - Aims: The influence of permanent atrial fibrillation on exercise tolerance and cardio-respiratory function during exercise in heart failure (HF) is unknown. Methods and results: We retrospectively compared the results of 942 cardiopulmonary exercise tests, performed consecutively at seven Italian laboratories, in HF patients with atrial fibrillation (n = 180) and sinus rhythm (n = 762). By multivariable logistic regression analysis, peak VO2 (OR 0.376, 95% CI 0.240-0.588, P <0.0001), O2pulse (VO 2/heart rate, HR) (OR 0.236, 95% CI 0.152-0.366, P <0.0001), VCO2 (OR 3.97, 95% CI 2.163-7.287, P <0.0001), and ventilation (OR 1.38, 95% CI 1.045-1.821, P = 0.0231) were independently associated with atrial fibrillation. Anaerobic threshold (AT) was identified in 132 of 180 (73%) atrial fibrillation and in 649 of 762 (85%) sinus rhythm patients (P = 0.0002). By multivariable logistic regression analysis, only peak VO2 (OR 0.214, 95% CI 0.155-0.296, P <0.0001) was independently associated with unidentified AT. At AT, atrial fibrillation HF patients had higher HR (P <0.0001) and higher VO2 (P <0.001) compared with sinus rhythm HF patients. Among AT variables, by multivariable logistic regression analysis, only HR was an independent predictor of atrial fibrillation. Conclusion: In HF patients with permanent atrial fibrillation, exercise performance is reduced as reflected by reduced peak VO2. The finding of unidentified AT is associated with a poor performance. In atrial fibrillation patients, VO 2 is higher at AT whereas lower at peak. This last observation raises uncertainties about the use of AT data to define performance and prognosis of HF patients with atrial fibrillation.
AB - Aims: The influence of permanent atrial fibrillation on exercise tolerance and cardio-respiratory function during exercise in heart failure (HF) is unknown. Methods and results: We retrospectively compared the results of 942 cardiopulmonary exercise tests, performed consecutively at seven Italian laboratories, in HF patients with atrial fibrillation (n = 180) and sinus rhythm (n = 762). By multivariable logistic regression analysis, peak VO2 (OR 0.376, 95% CI 0.240-0.588, P <0.0001), O2pulse (VO 2/heart rate, HR) (OR 0.236, 95% CI 0.152-0.366, P <0.0001), VCO2 (OR 3.97, 95% CI 2.163-7.287, P <0.0001), and ventilation (OR 1.38, 95% CI 1.045-1.821, P = 0.0231) were independently associated with atrial fibrillation. Anaerobic threshold (AT) was identified in 132 of 180 (73%) atrial fibrillation and in 649 of 762 (85%) sinus rhythm patients (P = 0.0002). By multivariable logistic regression analysis, only peak VO2 (OR 0.214, 95% CI 0.155-0.296, P <0.0001) was independently associated with unidentified AT. At AT, atrial fibrillation HF patients had higher HR (P <0.0001) and higher VO2 (P <0.001) compared with sinus rhythm HF patients. Among AT variables, by multivariable logistic regression analysis, only HR was an independent predictor of atrial fibrillation. Conclusion: In HF patients with permanent atrial fibrillation, exercise performance is reduced as reflected by reduced peak VO2. The finding of unidentified AT is associated with a poor performance. In atrial fibrillation patients, VO 2 is higher at AT whereas lower at peak. This last observation raises uncertainties about the use of AT data to define performance and prognosis of HF patients with atrial fibrillation.
KW - Anaerobic threshold
KW - Atrial fibrillation
KW - Cardiopulmonary exercise testing
KW - Heart failure
UR - http://www.scopus.com/inward/record.url?scp=53249087943&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=53249087943&partnerID=8YFLogxK
U2 - 10.1093/eurheartj/ehn361
DO - 10.1093/eurheartj/ehn361
M3 - Article
C2 - 18682448
AN - SCOPUS:53249087943
VL - 29
SP - 2367
EP - 2372
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 19
ER -