Dataset Information

Usefulness of ventilatory inefficiency in predicting prognosis across the heart failure spectrum.

ABSTRACT:

Aims

The minute ventilation-carbon dioxide production relationship (VE/VCO₂ slope) is widely used for prognostication in heart failure (HF) with reduced left ventricular ejection fraction (LVEF). This study explored the prognostic value of VE/VCO₂ slope across the spectrum of HF defined by ranges of LVEF.

Methods and results

In this single-centre retrospective observational study of 1347 patients with HF referred for cardiopulmonary exercise testing, patients with HF were categorized into HF with reduced (HFrEF, LVEF < 40%, n = 598), mid-range (HFmrEF, 40% ≤ LVEF < 50%, n = 164), and preserved (HFpEF, LVEF ≥ 50%, n = 585) LVEF. Four ventilatory efficiency categories (VC) were defined: VC-I, VE/VCO₂ slope ≤ 29; VC-II, 29 < VE/VCO₂ slope < 36; VC-III, 36 ≤ VE/VCO₂ slope < 45; and VC-IV, VE/VCO₂ slope ≥ 45. The associations of these VE/VCO₂ slope categories with a composite outcome of all-cause mortality or HF hospitalization were evaluated for each category of LVEF. Over a median follow-up of 2.0 (interquartile range: 1.9, 2.0) years, 201 patients experienced the composite outcome. Compared with patients in VC-I, those in VC-II, III, and IV demonstrated three-fold, five-fold, and eight-fold increased risk for the composite outcome. This incremental risk was observed across HFrEF, HFmrEF, and HFpEF cohorts.

Conclusions

Higher VE/VCO₂ slope is associated with incremental risk of 2 year all-cause mortality and HF hospitalization across the spectrum of HF defined by LVEF. A multilevel categorical approach to the interpretation of VE/VCO₂ slope may offer more refined risk stratification than the current binary approach employed in clinical practice.

SUBMITTER: Gong J

PROVIDER: S-EPMC8788025 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

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Publications

Usefulness of ventilatory inefficiency in predicting prognosis across the heart failure spectrum.

Gong Jingyi J Castro Renata R T RRT Caron Jesse P JP Bay Camden P CP Hainer Jon J Opotowsky Alexander R AR Mehra Mandeep R MR Maron Bradley A BA Di Carli Marcelo F MF Groarke John D JD Nohria Anju A

ESC heart failure 20211221 1

<h4>Aims</h4>The minute ventilation-carbon dioxide production relationship (VE/VCO<sub>2</sub> slope) is widely used for prognostication in heart failure (HF) with reduced left ventricular ejection fraction (LVEF). This study explored the prognostic value of VE/VCO<sub>2</sub> slope across the spectrum of HF defined by ranges of LVEF.<h4>Methods and results</h4>In this single-centre retrospective observational study of 1347 patients with HF referred for cardiopulmonary exercise testing, patients ...[more]

PMID: 34931762

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Dataset Information

Usefulness of ventilatory inefficiency in predicting prognosis across the heart failure spectrum.

Aims

Methods and results

Conclusions

Publications

Usefulness of ventilatory inefficiency in predicting prognosis across the heart failure spectrum.

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