Heart failure prognosis over time: how the prognostic role of oxygen consumption and ventilatory efficiency during exercise has changed in the last 20 years

被引：68

作者：

Paolillo, Stefania ^{[1
]}

Veglia, Fabrizio ^{[2
]}

Salvioni, Elisabetta ^{[2
]}

Corra, Ugo ^{[3
]}

Piepoli, Massimo ^{[4
]}

Lagioia, Rocco ^{[5
]}

Limongelli, Giuseppe ^{[6
]}

Sinagra, Gianfranco ^{[7
]}

Cattadori, Gaia ^{[8
]}

Scardovi, Angela B. ^{[9
]}

Metra, Marco ^{[10
]}

Senni, Michele ^{[11
]}

Bonomi, Alice ^{[2
]}

Scrutinio, Domenico ^{[5
]}

Raimondo, Rosa ^{[12
]}

Emdin, Michele ^{[13
,14
]}

Magri, Damiano ^{[15
]}

Parati, Gianfranco ^{[16
,17
]}

Re, Federica ^{[18
,19
]}

Cicoira, Mariantonietta ^{[20
]}

Mina, Chiara ^{[21
]}

Correale, Michele ^{[22
]}

Frigerio, Maria ^{[23
]}

Bussotti, Maurizio ^{[24
]}

Battaia, Elisa ^{[25
]}

Guazzi, Marco ^{[26
,27
]}

Badagliacca, Roberto ^{[28
]}

Di Lenarda, Andrea ^{[29
,30
]}

Maggioni, Aldo ^{[31
]}

Passino, Claudio ^{[13
,14
]}

Sciomer, Susanna ^{[28
]}

Pacileo, Giuseppe ^{[6
]}

Mapelli, Massimo ^{[2
]}

Vignati, Carlo ^{[2
]}

Clemenza, Francesco ^{[21
]}

Binno, Simone ^{[4
]}

Lombardi, Carlo ^{[10
]}

Filardi, Pasquale Perrone ^{[1
]}

Agostoni, Piergiuseppe ^{[2
,32
]}

Apostolo, Anna ^{[2
]}

Palermo, Pietro ^{[2
]}

Contini, Mauro ^{[2
]}

Farina, Stefania ^{[2
]}

Mantegazza, Valentina ^{[2
]}

Spadafora, Emanuele ^{[2
]}

Lattarulo, Maria Silvia ^{[2
]}

Giordano, Andrea ^{[33
]}

Mezzani, Alessandro ^{[33
]}

Ricci, Roberto ^{[34
]}

Ferraironi, Alessandro ^{[34
,35
]}

机构：

[1] Federico II Univ Naples, Dept Adv Biomed Sci, Naples, Italy

[2] IRCCS, Ctr Cardiol Monzino, Via Parea 4, I-20138 Milan, Italy

[3] IRCCS, Sci Inst Veruno, Salvatore Maugeri Fdn, Div Cardiac Rehabil, Veruno, Italy

[4] G de Saliceto Hosp, Div Cardiol, Piacenza, Italy

[5] IRCCS, Sci Inst Cassano Murge, Salvatore Maugeri Fdn, Div Cardiol, Bari, Italy

[6] Univ Naples 2, Monaldi Hosp, Azienda Colli, Cardiol SUN, Naples, Italy

[7] Osped Riuniti & Univ Trieste, Cardiovasc Dept, Trieste, Italy

[8] Multimed IRCCS, Div Cardiac Rehabil, Milan, Italy

[9] Santo Spirito Hosp, Cardiol Div, Rome, Italy

[10] Univ Brescia, Dept Med & Surg Specialties Radiol Sci & Publ Hlt, Cardiol, Brescia, Italy

[11] Papa Giovanni XXIII Hosp, Heart Failure & Heart Transplant Unit, Dept Cardiol, Bergamo, Italy

[12] IRCCS, Sci Inst Tradate, Salvatore Maugeri Fdn, Tradate, Italy

[13] CNR Reg Toscana, Gabriele Monasterio Fdn, Pisa, Italy

[14] Scuola Super Sant Anna, Life Sci Inst, Pisa, Italy

[15] Sapienza Univ Rome, St Andrea Hosp, Dept Clin & Mol Med, Rome, Italy

[16] Univ Milano Bicocca, Dept Med & Surg, Milan, Italy

[17] San Luca Hosp, Ist Auxol Italiano, Dept Cardiovasc Neural & Metab Sci, Milan, Italy

[18] San Camillo Forlanini Hosp, Cardiac Arrhythmia Ctr, Cardiol Div, Rome, Italy

[19] San Camillo Forlanini Hosp, Cardiomyopathies Unit, Rome, Italy

[20] Univ Verona, Dept Med, Sect Cardiol, Verona, Italy

[21] IRCCS, ISMETT, Dept Treatment & Study Cardiothorac Dis & Cardiot, Palermo, Italy

[22] Univ Foggia, Dept Cardiol, Foggia, Italy

[23] Osped Niguarda Ca Granda, A De Gasperis Cardiol Dept, Milan, Italy

[24] IRCCS, Sci Inst Milan, Salvatore Maugeri Fdn, Cardiac Rehabil Unit, Milan, Italy

[25] Santa Chiara Hosp, Dept Cardiol, Trento, Italy

[26] IRCCS, Policlin San Donato, San Donato Milanese, Cardiol Univ Dept,Heart Failure Unit, Milan, Italy

[27] IRCCS, Policlin San Donato, San Donato Milanese, Cardiopulmonary Lab, Milan, Italy

[28] Sapienza Univ Rome, Dept Cardiovasc Resp Nephrol Anesthesiol & Geriat, Rome, Italy

[29] Hlth Author 1, Cardiovasc Ctr, Trieste, Italy

[30] Univ Trieste, Trieste, Italy

[31] ANMCO Res Ctr, Florence, Italy

[32] Univ Milan, Dept Clin Sci & Community Hlth, Cardiovasc Sect, Milan, Italy

[33] IRCCS, Ist Sci Veruno, Fdn Salvatore Maugeri, Div Cardiol Riabilitat, Veruno, Italy

[34] Santo Spirito Hosp, Heart Failure Unit, Cardiol Univ Dept, Rome, Italy

[35] Santo Spirito Hosp, Cardiopulmonary Lab, Rome, Italy

[36] Azienda Osped Riuniti, Cardiol Riabilitat, Ancona, Italy

[37] Ist Auxol Italiano, Milan, Italy

[38] Osped Monaldi Napoli, Cardiol SUN, Naples, Italy

[39] CNR Milano, Milan, Italy

[40] Ist Clin Sci Maugeri, Cassano Delle Murge, Italy

[41] Ist Clin Sci Maugeri, Tradate, Italy

[42] Osped Riuniti & Univ Trieste, Trieste, Italy

[43] Ist Clin Sci Maugeri, Cardiac Rehabil Unit, Milan, Italy

[44] Osped Papa Giovanni XXIII, Bergamo, Italy

[45] CNR Reg Toscana, Fdn Gabriele Monasterio, Pisa, Italy

[46] Guglielmo da Saliceto Hosp, UOC Cardiol, Piacenza, Italy

[47] Osped Ca Granda AO Niguarda, Dipartimento Cardiol A De Gasperis, Milan, Italy

来源：

EUROPEAN JOURNAL OF HEART FAILURE | 2019年 / 21卷 / 02期

关键词：

Heart failure; Prognosis; Cardiopulmonary exercise test; Peak oxygen uptake; VE/VCO2; slope; CARDIAC TRANSPLANTATION; AMBULATORY PATIENTS; EUROPEAN-SOCIETY; KIDNEY INDEXES; MECKI SCORE; TASK-FORCE; DIAGNOSIS; GUIDELINES; SURVIVAL; COLLABORATION;

D O I：

10.1002/ejhf.1364

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：208 / 217

页数：10

共 12 条

[1] Combining peak oxygen consumption and ventilatory efficiency in the prognostic assessment of patients with heart failure
Bard, Robert L.
Gillespie, Brenda W.
Clarke, Nicholas S.
Nicklas, John M.
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2008, 123 (02) : 199 - 200
[2] The marine engineer's role - How has it changed over the last 40 years?
不详
MER-MARINE ENGINEERS REVIEW, 2007, : 34 - +
[3] Combining ventilatory efficiency and peak oxygen consumption in the prognosis assessment of patients with chronic heart failure
Toste, A.
Soares, R. M.
Feliciano, J.
Ramos, R.
Lousinha, A.
Hamad, H.
Andreozzi, V.
Silva, S.
Abreu, A.
Ferreira, R. C.
EUROPEAN HEART JOURNAL, 2008, 29 : 15 - 15
[4] Combining ventilatory efficiency and peak oxygen consumption in the prognostic assessment of patients with chronic heart failure
Toste, Alexandra
Soares, Rui M.
Feliciano, Joana
Andreozzi, Valeska
Silva, Sofia
Alves, Sandra
Ferreira, Lurdes
Abreu, Ana
Ferreira, Rui Cruz
REVISTA PORTUGUESA DE CARDIOLOGIA, 2010, 29 (09) : 1305 - 1320
[5] Effects of Respiratory Exchange Ratio on the Prognostic Value of Peak Oxygen Consumption and Ventilatory Efficiency in Patients With Systolic Heart Failure
Chase, Paul J.
Kenjale, Aarti
Cahalin, Lawrence P.
Arena, Ross
Davis, Paul G.
Myers, Jonathan
Guazzi, Marco
Forman, Daniel E.
Ashley, Euan
Peberdy, Mary Ann
West, Erin
Kelly, Christopher T.
Bensimhon, Daniel R.
JACC-HEART FAILURE, 2013, 1 (05) : 427 - 432
[6] VENTILATORY RESPONSE AND PEAK OXYGEN-CONSUMPTION DURING TREADMILL EXERCISE TEST IN CHILDREN WITH HEART-FAILURE
BOCCHI, EA
GUIMARAES, GV
WAJNGARTEN, M
BARRETO, ACP
PILEGGI, F
CIRCULATION, 1995, 92 (08) : 2786 - 2786
[7] Prognosis of heart failure in idiopathic dilated cardiomyopathy: has it improved in tertiary referral centres over the last 10 years?
Karagiannis, A
Tziomalos, K
Zamboulis, C
EUROPEAN HEART JOURNAL, 2004, 25 (21) : 1967 - 1967
[8] Prognosis in heart failure in the era of beta-blockers: role of severe exercise intolerance assessed by peak oxygen consumption
Cattadori, G.
Agostoni, P.
Salvioni, E.
Corra, U.
Parati, G.
Di Lenarda, A.
Piepoli, M.
Sinagra, G.
Emdin, M.
Metra, M.
EUROPEAN JOURNAL OF HEART FAILURE, 2013, 12 : S32 - S32
[9] Skeletal muscle mass independently predicts peak oxygen consumption and ventilatory response during exercise in noncachectic patients with chronic heart failure
Cicoira, M
Zanolla, L
Franceschini, L
Rossi, A
Golia, G
Zamboni, M
Tosoni, P
Zardini, P
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2001, 37 (08) : 2080 - 2085
[10] Chronic heart failure in the Russian Federation: what has changed over 20 years of follow-up? Results of the EPOCH-CHF study
Polyakov, D. S.
Fomin, I. V.
Belenkov, Yu. N.
Mareev, V. Yu.
Ageev, F. T.
Artem'eva, E. G.
Badin, Yu. V.
Bakulina, E. V.
Vinogradova, N. G.
Galyavich, A. S.
Ionova, T. S.
Kamalov, G. M.
Kechedzhieva, S. G.
Koziolova, N. A.
Malenkova, V. Yu.
Mal'chikova, S. V.
Mareev, Yu. V.
Smirnova, E. A.
Tarlovskaya, E. I.
Shcherbinina, E. V.
Yakushin, S. S.
KARDIOLOGIYA, 2021, 61 (04) : 4 - 14

← 1 2 →