Dataset Information

The Prognostic Value of Peak Cardiac Power Output in Chinese Patients with Chronic Heart Failure.

ABSTRACT:

Background

Cardiopulmonary exercise testing has been widely used to risk stratify patients with chronic heart failure (CHF). Peak oxygen consumption (peakVO2) was regarded as a powerful predictor of survival, as it is a surrogate for peak cardiac output (CO), which by most is considered the "true" measure of heart failure. Therefore, it is reasonable to hypothesize that CO is an even stronger predictor than peak VO2. The present study is aimed to investigate the prognostic value of peak cardiac power output (peak CPO) in comparison with peakVO2 in Chinese patients with CHF.

Methods

Participants provided written informed consent to participate in this study. Totally 129 patients with CHF underwent symptom-limited cardiopulmonary exercise testing (CPET), with mean age 59.1 ± 11.4 years, 87.6% male, 57.4% ischemic etiology, body mass index (BMI) 24.7 ± 3.7 kg/m(2) and LVEF 38 ± 9%. CO was measured using an inert gas rebreathing method. The primary endpoints are cardiac deaths.

Results

Over median 33.7-month follow-up, 19 cardiac deaths were reported. Among peak VO2,VE/VCO2 slope and Peak CPO, their area under ROC were 0.64, 0.67, 0.68, respectively (?<0.05).The optimal thresholds for predicting cardiac deaths were peak VO2 ? 13.4 ml.kg(-1).min(-1), and VE/VCO2 slope ? 39.3 and peak CPO? 1.1 respectively by ROC analysis. Finally, in patients with a peak VO2 ? 13.4 ml.kg(-1).min(-1) those with peak CPO>1.1W had better survival than those with peak CPO ? 1.1W. However, by multivariate analysis adjusted for age, sex, BMI, resting heart rate, LVMI, LVEF, Peak CPO was not an independent predictor of cardiac deaths (P> 0.05).

Conclusions

Peak CPO was not a predictor of cardiac death in Chinese CHF patients.

SUBMITTER: Shen Y

PROVIDER: S-EPMC4726448 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The Prognostic Value of Peak Cardiac Power Output in Chinese Patients with Chronic Heart Failure.

Shen Yuqin Y Song Haoming H Ma Wenlin W Gong Zhu Z Ni Yi Y Zhang Xiaoyu X Xu Wenjun W Jiang Jinfa J Che Lin L Xu Jiahong J Yan Wenwen W Zhou Lin L Li Guanghe G Zhang Qiping Q Wang Lemin L

PloS one 20160125 1

<h4>Background</h4>Cardiopulmonary exercise testing has been widely used to risk stratify patients with chronic heart failure (CHF). Peak oxygen consumption (peakVO2) was regarded as a powerful predictor of survival, as it is a surrogate for peak cardiac output (CO), which by most is considered the "true" measure of heart failure. Therefore, it is reasonable to hypothesize that CO is an even stronger predictor than peak VO2. The present study is aimed to investigate the prognostic value of peak ...[more]

PMID: 26808510

Similar Datasets

Project description:BackgroundWe investigated whether repeatedly measured global longitudinal strain (GLS) has incremental prognostic value over repeatedly measured left ventricular ejection fraction (LVEF) and N-terminal pro B-type natriuretic peptide (NT-proBNP), and a single "baseline" GLS value, in chronic heart failure (HF) patients.MethodsIn this prospective observational study, echocardiography was performed in 173 clinically stable chronic HF patients every six months during follow up. During a median follow-up of 2.7 years, a median of 3 (25th-75th percentile:2-4) echocardiograms were obtained per patient. The endpoint was a composite of HF hospitalization, left ventricular assist device, heart transplantation, cardiovascular death. We compared hazard ratios (HRs) for the endpoint from Cox models (used to analyze the first available GLS measurements) with HRs from joint models (which links repeated measurements to the time-to-event data).ResultsMean age was 58 ± 11 years, 76% were men, 81% were in New York Heart Association functional class I/II, and all had LVEF < 50% (mean ± SD: 27 ± 9%). The endpoint was reached by 53 patients. GLS was persistently decreased over time in patients with the endpoint. However, temporal GLS trajectories did not further diverge in patients with versus without the endpoint and remained stable during follow-up. Both single measurements and temporal trajectories of GLS were significantly associated with the endpoint [HR per SD change (95%CI): 2.15(1.34-3.46), 3.54 (2.01-6.20)]. In a multivariable model, repeatedly measured GLS maintained its prognostic value while repeatedly measured LVEF did not [HR per SD change (95%CI): GLS:4.38 (1.49-14.70), LVEF:1.14 (0.41-3.23)]. The association disappeared when correcting for repeatedly measured NT-proBNP.ConclusionTemporal evolution of GLS was associated with adverse events, independent of LVEF but not independent of NT-proBNP. Since GLS showed decreased but stable values in patients with adverse prognosis, single measurements of GLS provide sufficient information for determining prognosis in clinical practice compared to repeated measurements, and temporal GLS patterns do not add prognostic information to NT-proBNP.

Dataset Information

The Prognostic Value of Peak Cardiac Power Output in Chinese Patients with Chronic Heart Failure.

Background

Methods

Results

Conclusions

Publications

The Prognostic Value of Peak Cardiac Power Output in Chinese Patients with Chronic Heart Failure.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets