Peak Exercise Oxygen Uptake Predicts Recurrent Admissions in Heart Failure With Preserved Ejection Fraction
Por:
Palau, P, DOMÍNGUEZ MAFÉ, E, Nunez, E, Maria Ramon, J, Lopez, L, Melero, J, Sanchis, J, Beliver, A, Santas, E, Bayes-Genis, A, Chorro, F and Nunez, J
Publicada:
1 abr 2018
Categoría:
Cardiology and cardiovascular medicine
Resumen:
Introduction and objectives: Heart failure with preserved ejection
fraction (HFpEF) is a highly prevalent syndrome with an elevated risk of
morbidity and mortality. To date, there is scarce evidence on the role
of peak exercise oxygen uptake (peak VO2) for predicting the morbidity
burden in HFpEF. We sought to evaluate the association between peak VO2
and the risk of recurrent hospitalizations in patients with HFpEF.
Methods: A total of 74 stable symptomatic patients with HFpEF underwent
a cardiopulmonary exercise test between June 2012 and May 2016. A
negative binomial regression method was used to determine the
association between the percentage of predicted peak VO2 (pp-peak V02)
and recurrent hospitalizations. Risk estimates are reported as incidence
rate ratios.
Results: The mean age was 72.5 +/- 9.1 years, 53% were women, and all
patients were in New York Heart Association functional class II to III.
Mean peak VO2 and median pp-peak VO2 were 10 +/- 2.8 mL/min/kg and 60%
(range, 47-67), respectively. During a median follow-up of 276 days
[interquartile range, 153-1231], 84 all-cause hospitalizations in 31
patients (41.9%) were registered. A total of 15 (20.3%) deaths were also
recorded. On multivariate analysis, accounting for mortality as a
terminal event, pp-peak VO2 was independently and linearly associated
with the risk of recurrent admission. Thus, and modeled as continuous, a
10% decrease of pp-peak VO2 increased the risk of recurrent
hospitalizations by 32% (IRR, 1.32; 95%CI, 1.03-1.68; P = .028).
Conclusions: In symptomatic elderly patients with HFpEF, pp-peak VO2
predicts all-cause recurrent admission. (C) 2017 Sociedad Espafiola de
Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.
Filiaciones:
:
Univ Jaume 1, Hosp Gen Univ Castellon, Serv Cardiol, Castellon de La Plana, Spain
:
Univ Jaume 1, Hosp Gen Univ Castellon, Serv Cardiol, Castellon de La Plana, Spain
Nunez, E:
Univ Valencia, Hosp Clin Univ, INCLIVA, Serv Cardiol, Valencia, Spain
Maria Ramon, J:
Univ Valencia, Hosp Clin Univ, INCLIVA, Serv Cardiol, Valencia, Spain
Lopez, L:
Univ Valencia, Dept Fisioterapia, Valencia, Spain
:
Univ Jaume 1, Hosp Gen Univ Castellon, Serv Cardiol, Castellon de La Plana, Spain
Sanchis, J:
Univ Valencia, Hosp Clin Univ, INCLIVA, Serv Cardiol, Valencia, Spain
CIBER Cardiovasc, Madrid, Spain
:
Univ Jaume 1, Hosp Gen Univ Castellon, Serv Cardiol, Castellon de La Plana, Spain
Santas, E:
Univ Valencia, Hosp Clin Univ, INCLIVA, Serv Cardiol, Valencia, Spain
Bayes-Genis, A:
CIBER Cardiovasc, Madrid, Spain
Univ Autonoma Barcelona, Hosp Univ Germans Trias i Pujol, Dept Med, Serv Cardiol, Barcelona, Spain
Chorro, F:
Univ Valencia, Hosp Clin Univ, INCLIVA, Serv Cardiol, Valencia, Spain
Nunez, J:
Univ Valencia, Hosp Clin Univ, INCLIVA, Serv Cardiol, Valencia, Spain
CIBER Cardiovasc, Madrid, Spain
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