The prognostic value of ventilatory efficiency with beta-blocker therapy in heart failure

Ross A. Arena, Marco Guazzi, Jonathan Myers, Joshua Abella

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

PURPOSE: Beta-blockade (BB) has been shown to improve outcomes among patients with heart failure (HF). The impact this pharmacological approach has on the prognostic information gained from cardiopulmonary exercise testing (CPX) is, however, unclear. METHODS: Four hundred seventeen subjects diagnosed with HF underwent CPX. The numbers of subjects prescribed and not prescribed a BB agent were 167 and 250, respectively. Subjects were tracked for cardiac-related mortality after CPX. RESULTS: Values are reported for the no-BB versus the BB group throughout. Age (57.9 ± 13.3 vs 55.6 ± 12.5), peak V̇O2 (16.2 ± 5.7 vs 16.5 ± 5.5 mL·kg·min), VE/V̇CO2 slope (34.2 ± 9.0 vs 33.2 ± 7.4), and peak RER (1.07 ± 0.16 vs 1.05 ± 0.14) were similar between groups (P > 0.05). Multivariate Cox regression analysis revealed that the VE/V̇CO2 slope was the superior predictor of death in both groups (chi-square: 71.9, P <0.001; and 18.4, P <0.001). The optimal threshold values for VE/V̇CO2 slope in the no-BB and BB groups were 36.0 and 34.3, respectively. CONCLUSIONS: The results of the present study indicate that BB does not alter the prognostic value/characteristics of the VE/V̇CO2 slope. Findings from previous investigations examining the prognostic significance of CPX predominantly using HF groups not receiving a BB agent may, therefore, still be applicable in modern-day clinical practice.

Original languageEnglish
Pages (from-to)213-219
Number of pages7
JournalMedicine and Science in Sports and Exercise
Volume39
Issue number2
DOIs
Publication statusPublished - Feb 2007

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Heart Failure
Therapeutics
Regression Analysis
Pharmacology
Exercise
Mortality

Keywords

  • Exercise testing
  • Metabolic analysis
  • Mortality
  • Oxygen uptake

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Orthopedics and Sports Medicine

Cite this

The prognostic value of ventilatory efficiency with beta-blocker therapy in heart failure. / Arena, Ross A.; Guazzi, Marco; Myers, Jonathan; Abella, Joshua.

In: Medicine and Science in Sports and Exercise, Vol. 39, No. 2, 02.2007, p. 213-219.

Research output: Contribution to journalArticle

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abstract = "PURPOSE: Beta-blockade (BB) has been shown to improve outcomes among patients with heart failure (HF). The impact this pharmacological approach has on the prognostic information gained from cardiopulmonary exercise testing (CPX) is, however, unclear. METHODS: Four hundred seventeen subjects diagnosed with HF underwent CPX. The numbers of subjects prescribed and not prescribed a BB agent were 167 and 250, respectively. Subjects were tracked for cardiac-related mortality after CPX. RESULTS: Values are reported for the no-BB versus the BB group throughout. Age (57.9 ± 13.3 vs 55.6 ± 12.5), peak V̇O2 (16.2 ± 5.7 vs 16.5 ± 5.5 mL·kg·min), VE/V̇CO2 slope (34.2 ± 9.0 vs 33.2 ± 7.4), and peak RER (1.07 ± 0.16 vs 1.05 ± 0.14) were similar between groups (P > 0.05). Multivariate Cox regression analysis revealed that the VE/V̇CO2 slope was the superior predictor of death in both groups (chi-square: 71.9, P <0.001; and 18.4, P <0.001). The optimal threshold values for VE/V̇CO2 slope in the no-BB and BB groups were 36.0 and 34.3, respectively. CONCLUSIONS: The results of the present study indicate that BB does not alter the prognostic value/characteristics of the VE/V̇CO2 slope. Findings from previous investigations examining the prognostic significance of CPX predominantly using HF groups not receiving a BB agent may, therefore, still be applicable in modern-day clinical practice.",
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N2 - PURPOSE: Beta-blockade (BB) has been shown to improve outcomes among patients with heart failure (HF). The impact this pharmacological approach has on the prognostic information gained from cardiopulmonary exercise testing (CPX) is, however, unclear. METHODS: Four hundred seventeen subjects diagnosed with HF underwent CPX. The numbers of subjects prescribed and not prescribed a BB agent were 167 and 250, respectively. Subjects were tracked for cardiac-related mortality after CPX. RESULTS: Values are reported for the no-BB versus the BB group throughout. Age (57.9 ± 13.3 vs 55.6 ± 12.5), peak V̇O2 (16.2 ± 5.7 vs 16.5 ± 5.5 mL·kg·min), VE/V̇CO2 slope (34.2 ± 9.0 vs 33.2 ± 7.4), and peak RER (1.07 ± 0.16 vs 1.05 ± 0.14) were similar between groups (P > 0.05). Multivariate Cox regression analysis revealed that the VE/V̇CO2 slope was the superior predictor of death in both groups (chi-square: 71.9, P <0.001; and 18.4, P <0.001). The optimal threshold values for VE/V̇CO2 slope in the no-BB and BB groups were 36.0 and 34.3, respectively. CONCLUSIONS: The results of the present study indicate that BB does not alter the prognostic value/characteristics of the VE/V̇CO2 slope. Findings from previous investigations examining the prognostic significance of CPX predominantly using HF groups not receiving a BB agent may, therefore, still be applicable in modern-day clinical practice.

AB - PURPOSE: Beta-blockade (BB) has been shown to improve outcomes among patients with heart failure (HF). The impact this pharmacological approach has on the prognostic information gained from cardiopulmonary exercise testing (CPX) is, however, unclear. METHODS: Four hundred seventeen subjects diagnosed with HF underwent CPX. The numbers of subjects prescribed and not prescribed a BB agent were 167 and 250, respectively. Subjects were tracked for cardiac-related mortality after CPX. RESULTS: Values are reported for the no-BB versus the BB group throughout. Age (57.9 ± 13.3 vs 55.6 ± 12.5), peak V̇O2 (16.2 ± 5.7 vs 16.5 ± 5.5 mL·kg·min), VE/V̇CO2 slope (34.2 ± 9.0 vs 33.2 ± 7.4), and peak RER (1.07 ± 0.16 vs 1.05 ± 0.14) were similar between groups (P > 0.05). Multivariate Cox regression analysis revealed that the VE/V̇CO2 slope was the superior predictor of death in both groups (chi-square: 71.9, P <0.001; and 18.4, P <0.001). The optimal threshold values for VE/V̇CO2 slope in the no-BB and BB groups were 36.0 and 34.3, respectively. CONCLUSIONS: The results of the present study indicate that BB does not alter the prognostic value/characteristics of the VE/V̇CO2 slope. Findings from previous investigations examining the prognostic significance of CPX predominantly using HF groups not receiving a BB agent may, therefore, still be applicable in modern-day clinical practice.

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