Prediction of mortality in mild to moderately symptomatic patients with left ventricular dysfunction: The role of the New York Heart Association classification, cardiopulmonary exercise testing, two-dimensional echocardiography and Holtér monitoring

D. Scrutinio, R. Lagioia, A. Ricci, M. Clemente, L. Boni, P. Rizzon

Research output: Contribution to journalArticle

Abstract

In order to investigate the value of peak oxygen consumption (peak VO2) in predicting mortality in mild to moderately symptomatic patients with left ventricular dysfunction, we studied 103 NYHA II/III class patients with a left ventricular ejection fraction (LVEF) ≤40%. Heart failure was due to coronary artery disease (CAD) in 39 patients, idiopathic dilated cardiomyopathy in 54, hypertension in eight and surgically corrected valvular disease in two. The following variables were analysed: age, cause of heart failure (CAD vs no CAD), NYHA class, peak VO2, LVEF, left ventricular end-systolic volume index (LVESVI), ventricular tachycardia (VT) on Hotter monitoring and the use of antiarrhythmic drugs. Statistical analysis was performed by Cox's proportional-hazards regression model. During a mean follow-up period of 20 months, there were 25 deaths. The estimated cumulative probabilities of survival were 88%, 73% and 58% at 1, 2 and 3 years, respectively. Cox's model identified CAD (P=0.01), NYHA III class (P=0.04) and LVEF (P=0.02) as independent, statistically significant predictors of mortality. Peak VO2 had only a marginal statistical significance (P=0.07). Age, LVESVI, VT on Holler monitoring and use of antiarrhythmic drugs were not related to mortality. These data can be important in patient clinical management and clinical trial design.

Original languageEnglish
Pages (from-to)1089-1095
Number of pages7
JournalEuropean Heart Journal
Volume15
Issue number8
Publication statusPublished - 1994

Keywords

  • Chronic heart failure
  • Peak oxygen consumption
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Statistics, Probability and Uncertainty
  • Applied Mathematics
  • Physiology (medical)
  • Physiology

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