Heart failure prognosis over time : how the prognostic role of oxygen consumption and ventilatory efficiency during exercise has changed in the last 20 years
© 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiology..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:21 |
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| Enthalten in: |
European journal of heart failure - 21(2019), 2 vom: 18. Feb., Seite 208-217 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Paolillo, Stefania [VerfasserIn] |
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| Links: |
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| Themen: |
Cardiopulmonary exercise test |
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| Anmerkungen: |
Date Completed 21.05.2019 Date Revised 21.05.2019 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1002/ejhf.1364 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM292609221 |
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| 041 | |a eng | ||
| 100 | 1 | |a Paolillo, Stefania |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Heart failure prognosis over time |b how the prognostic role of oxygen consumption and ventilatory efficiency during exercise has changed in the last 20 years |
| 264 | 1 | |c 2019 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 21.05.2019 | ||
| 500 | |a Date Revised 21.05.2019 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiology. | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Cardiopulmonary exercise test | |
| 650 | 4 | |a Heart failure | |
| 650 | 4 | |a Peak oxygen uptake | |
| 650 | 4 | |a Prognosis | |
| 650 | 4 | |a VE/VCO2 slope | |
| 700 | 1 | |a Veglia, Fabrizio |e verfasserin |4 aut | |
| 700 | 1 | |a Salvioni, Elisabetta |e verfasserin |4 aut | |
| 700 | 1 | |a Corrà, Ugo |e verfasserin |4 aut | |
| 700 | 1 | |a Piepoli, Massimo |e verfasserin |4 aut | |
| 700 | 1 | |a Lagioia, Rocco |e verfasserin |4 aut | |
| 700 | 1 | |a Limongelli, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Sinagra, Gianfranco |e verfasserin |4 aut | |
| 700 | 1 | |a Cattadori, Gaia |e verfasserin |4 aut | |
| 700 | 1 | |a Scardovi, Angela B |e verfasserin |4 aut | |
| 700 | 1 | |a Metra, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Senni, Michele |e verfasserin |4 aut | |
| 700 | 1 | |a Bonomi, Alice |e verfasserin |4 aut | |
| 700 | 1 | |a Scrutinio, Domenico |e verfasserin |4 aut | |
| 700 | 1 | |a Raimondo, Rosa |e verfasserin |4 aut | |
| 700 | 1 | |a Emdin, Michele |e verfasserin |4 aut | |
| 700 | 1 | |a Magrì, Damiano |e verfasserin |4 aut | |
| 700 | 1 | |a Parati, Gianfranco |e verfasserin |4 aut | |
| 700 | 1 | |a Re, Federica |e verfasserin |4 aut | |
| 700 | 1 | |a Cicoira, Mariantonietta |e verfasserin |4 aut | |
| 700 | 1 | |a Minà, Chiara |e verfasserin |4 aut | |
| 700 | 1 | |a Correale, Michele |e verfasserin |4 aut | |
| 700 | 1 | |a Frigerio, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Bussotti, Maurizio |e verfasserin |4 aut | |
| 700 | 1 | |a Battaia, Elisa |e verfasserin |4 aut | |
| 700 | 1 | |a Guazzi, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Badagliacca, Roberto |e verfasserin |4 aut | |
| 700 | 1 | |a Di Lenarda, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Maggioni, Aldo |e verfasserin |4 aut | |
| 700 | 1 | |a Passino, Claudio |e verfasserin |4 aut | |
| 700 | 1 | |a Sciomer, Susanna |e verfasserin |4 aut | |
| 700 | 1 | |a Pacileo, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Mapelli, Massimo |e verfasserin |4 aut | |
| 700 | 1 | |a Vignati, Carlo |e verfasserin |4 aut | |
| 700 | 1 | |a Clemenza, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Binno, Simone |e verfasserin |4 aut | |
| 700 | 1 | |a Lombardi, Carlo |e verfasserin |4 aut | |
| 700 | 1 | |a Filardi, Pasquale Perrone |e verfasserin |4 aut | |
| 700 | 1 | |a Agostoni, Piergiuseppe |e verfasserin |4 aut | |
| 700 | 0 | |a MECKI Score Research Group (see Appendix) |e verfasserin |4 aut | |
| 700 | 1 | |a Apostolo, Anna |e investigator |4 oth | |
| 700 | 1 | |a Palermo, Pietro |e investigator |4 oth | |
| 700 | 1 | |a Contini, Mauro |e investigator |4 oth | |
| 700 | 1 | |a Farina, Stefania |e investigator |4 oth | |
| 700 | 1 | |a Mantegazza, Valentina |e investigator |4 oth | |
| 700 | 1 | |a Spadafora, Emanuele |e investigator |4 oth | |
| 700 | 1 | |a Lattarulo, Maria Silvia |e investigator |4 oth | |
| 700 | 1 | |a Giordano, Andrea |e investigator |4 oth | |
| 700 | 1 | |a Mezzani, Alessandro |e investigator |4 oth | |
| 700 | 1 | |a Ricci, Roberto |e investigator |4 oth | |
| 700 | 1 | |a Ferraironi, Alessandro |e investigator |4 oth | |
| 700 | 1 | |a Carubelli, Valentina |e investigator |4 oth | |
| 700 | 1 | |a Pietrucci, Francesca |e investigator |4 oth | |
| 700 | 1 | |a Malfatto, Gabriella |e investigator |4 oth | |
| 700 | 1 | |a Caravita, Sergio |e investigator |4 oth | |
| 700 | 1 | |a Viganò, Elena |e investigator |4 oth | |
| 700 | 1 | |a Valente, Fabio |e investigator |4 oth | |
| 700 | 1 | |a Vastarella, Rossella |e investigator |4 oth | |
| 700 | 1 | |a Gravino, Rita |e investigator |4 oth | |
| 700 | 1 | |a Roselli, Teo |e investigator |4 oth | |
| 700 | 1 | |a Buono, Andrea |e investigator |4 oth | |
| 700 | 1 | |a De Maria, Renata |e investigator |4 oth | |
| 700 | 1 | |a Passantino, Andrea |e investigator |4 oth | |
| 700 | 1 | |a Santoro, Daniela |e investigator |4 oth | |
| 700 | 1 | |a Campanale, Saba |e investigator |4 oth | |
| 700 | 1 | |a Caputo, Domenica |e investigator |4 oth | |
| 700 | 1 | |a Bertipaglia, Donatella |e investigator |4 oth | |
| 700 | 1 | |a Confalonieri, Marco |e investigator |4 oth | |
| 700 | 1 | |a Gentile, Piero |e investigator |4 oth | |
| 700 | 1 | |a Zambon, Elena |e investigator |4 oth | |
| 700 | 1 | |a Morosin, Marco |e investigator |4 oth | |
| 700 | 1 | |a Carriere, Cosimo |e investigator |4 oth | |
| 700 | 1 | |a Ferraretti, Armando |e investigator |4 oth | |
| 700 | 1 | |a Marchese, Giovanni |e investigator |4 oth | |
| 700 | 1 | |a Iorio, Annamaria |e investigator |4 oth | |
| 700 | 1 | |a Pastormerlo, Luigi |e investigator |4 oth | |
| 700 | 1 | |a Gargiulo, Paola |e investigator |4 oth | |
| 700 | 1 | |a Villani, Giovanni Quinto |e investigator |4 oth | |
| 700 | 1 | |a Oliva, Fabrizio |e investigator |4 oth | |
| 700 | 1 | |a Perna, Enrico |e investigator |4 oth | |
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