Heart failure Prognosis over time: how the prognostic role of peak VO2 and ventilation efficiency during exercise has changed in the last 20 years : On behalf of the MECKI score research group
Altro
Data di Pubblicazione:
2018
Citazione:
Heart failure Prognosis over time: how the prognostic role of peak VO2 and ventilation efficiency during exercise has changed in the last 20 years : On behalf of the MECKI score research group / S. Paolillo, F. Veglia, E. Salvioni, A. Bonomi, U. Corra´, M. Piepoli, R. Lagioia, A.B. Scardovi, M. Metra, M. Correale, M. Emdin, G. Parati, M. Mapelli, C. Vignati, R. Raimondo, G. Limongelli, R. Badagliacca, D. Magrì, G. Sinagra, P. Perrone Filardi, P. Agostoni. ((Intervento presentato al 79. convegno Congresso Società Italiana di Cardiologia (SIC) tenutosi a Roma nel 2018.
Abstract:
Aims
Exercise‐derived parameters, specifically peak exercise oxygen uptake (peak VO2) and
minute ventilation/carbon dioxide relationship slope (VE/VCO2 slope), have a pivotal
prognostic value in heart failure (HF). It is unknown how the prognostic threshold of peak
VO2 and VE/VCO2 slope has changed over the last 20 years in parallel with HF prognosis
improvement.
Methods and results
Data from 6083 HF patients (81% male, age 61 ±13 years), enrolled in the MECKI score
database between 1993 and 2015, were retrospectively analysed. By enrolment year, four
groups were generated: group 1 1993–2000 (n =440), group 2 2001–2005 (n =1288),
group 3 2006–2010 (n =2368), and group 4 2011–2015 (n =1987). We compared the 10‐
year survival of groups and analysed how the overall risk (cardiovascular death, urgent
heart transplantation, or left ventricular assist device implantation) changed over time
according to peak VO2 and VE/VCO2 slope and to major clinical and therapeutic
variables. At 10 years, a progressively higher survival from group 1 to group 3 was
observed, with no further improvement afterwards. A 20% risk for peak VO2 15 mL/min/kg
(95% confidence interval 16–13), 9 (11–8), 4 (4–2) and 5 (7–4) was observed in group 1,
2, 3, and 4, respectively, while the VE/VCO2 slope value for a 20% risk was 32 (37–29),
47 (51–43), 59 (64–55), and 57 (63–52), respectively.
Conclusions
Heart failure prognosis improved over time up to 2010 in a HF population followed by
experienced centres. The peak VO2 and VE/VCO2 slope cut‐offs identifying a definite risk
progressively decreased and increased over time, respectively. The prognostic threshold
of peak VO2 and VE/VCO2 slope must be updated whenever HF prognosis improves.
Tipologia IRIS:
14 - Intervento a convegno non pubblicato
Elenco autori:
S. Paolillo, F. Veglia, E. Salvioni, A. Bonomi, U. Corra´, M. Piepoli, R. Lagioia, A.B. Scardovi, M. Metra, M. Correale, M. Emdin, G. Parati, M. Mapelli, C. Vignati, R. Raimondo, G. Limongelli, R. Badagliacca, D. Magrì, G. Sinagra, P. Perrone Filardi, P. Agostoni
Link alla scheda completa: