VE/VCO2 slope and peak VO2 interact and define a non-linear prognostic "risk surface" in chronic heart failure

D. P. Francis, W. Shamim, L. C. Davies, J. S. Chambers, S. D. Anker, A. J S Coats

Research output: Contribution to journalArticle

Abstract

Background: Reduced peak oxygen consumption (peak VO2) during exercise is a known adverse prognostic factor in chronic heart failure (CHF). However, another feature, increased exercise hyperpnea (VE/VCO2 slope), may also be an adverse marker. Methods: 301 CHF patients underwent treadmill cardiopulmonary exercise testing, using a modified Bruce protocol. Peak VO2 and VE/VCO2 slope were determined using a pneumotachograph and mass spectrometer (Amis, DK). Results: During a median follow-up of 33 months (range 24-68), 87 patients died. Univariate Cox proportional-hazards analysis revealed powerful predictive value in both peak VO2 and VE/VCO2 slope (p2 (p=0.0003) and VE/VCO2 slope (p2 and VE/VCO2 slope, using a model which does not assume linearity of risk or of interaction between peak VO2 and VE/VCO2 slope. Conclusion: During cardiopulmonary exercise testing, it is important to take note of the VE/VCO2 slope, as it gives valuable prognostic information independent of peak VO2. In the worst prognostic group by peak VO2 (2 slope into a range of 2-year mortalities from 20% to 60%. Even in the best prognostic group by peak VO2, enhanced VE/VCO2 slope identifies a subgroup at elevated risk. (Graph Presented).

Original languageEnglish
JournalHeart
Volume81
Issue numberSUPPL. 1
Publication statusPublished - May 1999

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Francis, D. P., Shamim, W., Davies, L. C., Chambers, J. S., Anker, S. D., & Coats, A. J. S. (1999). VE/VCO2 slope and peak VO2 interact and define a non-linear prognostic "risk surface" in chronic heart failure. Heart, 81(SUPPL. 1).