Clinical Utility of the Cardiorespiratory Optimal Point in Patients with Heart Failure.
Med Sci Sports Exerc
; 55(10): 1727-1734, 2023 10 01.
Article
en En
| MEDLINE
| ID: mdl-37192340
ABSTRACT
INTRODUCTION:
We assessed the cardiorespiratory optimal point (COP)-the minimal VÌE /VÌO 2 in a given minute of an incremental cardiopulmonary exercise test-in patients with heart failure (HF) and aimed to determine 1) its association with patient and disease characteristics, 2) changes after an exercise-based cardiac rehabilitation program (CR), and 3) the association with clinical outcomes.METHODS:
We studied 277 HF patients (67 (58-74) yr, 30% female, 72% HF with restricted ejection fraction) between 2009 and 2018. Patients participated in a 12- to 24-wk CR program, and COP was assessed pre- and post-CR. Patient and disease characteristics and clinical outcomes (mortality and cardiovascular-related hospitalization) were extracted from patient files. The incidence of clinical outcomes was compared across COP tertiles (low, <26.0; moderate, 26.0-30.7; high, >30.7).RESULTS:
Median COP was 28.2 (24.9-32.1) and was reached at 51% ± 15% of VÌO 2peak . Lower age, female sex, higher body mass index, the absence of a pacemaker or the absence of chronic obstructive pulmonary disease, and lower N-terminal prohormone brain natriuretic peptide concentrations were associated with a lower COP. Participation in CR reduced COP (-0.8; 95% confidence interval, -1.3 to -0.3). Low COP had a reduced risk (adjusted hazard ratio, 0.53; 95% confidence interval, 0.33-0.84) for adverse clinical outcomes as compared with high COP.CONCLUSIONS:
Classic cardiovascular risk factors are associated with a higher, more unfavorable, COP. CR-based exercise training reduces COP, whereas a lower COP is associated with a better clinical prognosis. As COP can be established during a submaximal exercise test, this may offer novel risk stratification possibilities for HF care programs.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Rehabilitación Cardiaca
/
Insuficiencia Cardíaca
Tipo de estudio:
Prognostic_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
Med Sci Sports Exerc
Año:
2023
Tipo del documento:
Article
País de afiliación:
Países Bajos