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

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Heart Failure
Exercise
Oxygen Consumption
Mortality

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).

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

In: Heart, Vol. 81, No. SUPPL. 1, 05.1999.

Research output: Contribution to journalArticle

Francis, DP, Shamim, W, Davies, LC, Chambers, JS, Anker, SD & Coats, AJS 1999, 'VE/VCO2 slope and peak VO2 interact and define a non-linear prognostic "risk surface" in chronic heart failure', Heart, vol. 81, no. SUPPL. 1.
Francis DP, Shamim W, Davies LC, Chambers JS, Anker SD, Coats AJS. VE/VCO2 slope and peak VO2 interact and define a non-linear prognostic "risk surface" in chronic heart failure. Heart. 1999 May;81(SUPPL. 1).
Francis, D. P. ; Shamim, W. ; Davies, L. C. ; Chambers, J. S. ; Anker, S. D. ; Coats, A. J S. / VE/VCO2 slope and peak VO2 interact and define a non-linear prognostic "risk surface" in chronic heart failure. In: Heart. 1999 ; Vol. 81, No. SUPPL. 1.
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AU - Francis, D. P.

AU - Shamim, W.

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AU - Anker, S. D.

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N2 - 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).

AB - 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).

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