Observed change in peak oxygen consumption after aortic valve replacement and its predictors.
Open Heart
; 3(1): e000309, 2016.
Article
em En
| MEDLINE
| ID: mdl-27252876
ABSTRACT
OBJECTIVE:
To assess the change in peak oxygen consumption (pVO2) and determine its outcome predictors after aortic valve replacement (AVR) for aortic stenosis (AS).METHODS:
Patients with AS and preserved left ventricular ejection fraction who were referred for single AVR had cardiopulmonary exercise testing prior to and 9â months post-AVR. Predictors of outcome for pVO2 were determined by multivariate linear and logistic regression analyses. A significant change in pVO2 was defined as a relative change that was more than twice the coefficient of repeatability by test-retest (>10%).RESULTS:
The pre-AVR characteristics of the 37 study patients included the following median age (range) 72 (46-83) years, aortic valve area index (AVAI) 0.41 (SD 0.11) cm(2)/m(2), mean gradient (MG) 49.1 (SD 15.3) mmâ Hg and New York Heart Association (NYHA)≥II 27 (73%). Pre-AVR and post-AVR mean pVO2 was 18.5 and 18.4â mL/kg/m(2) (87% of the predicted), respectively, but the change from pre-AVR was heterogeneous. The relative change in pVO2 was positively associated with the preoperative MG (ß=0.50, p=0.001) and negatively associated with brain natriuretic peptide > upper level of normal according to age and gender (ß=-0.40, p=0.009). A relative increase in pVO2 exceeding 10% was found in 9 (24%), predicted by lower pre-AVR AVAI (OR 0.18; 95% CI 0.04 to 0.82, p=0.027) and lower peak O2 pulse (OR 0.94; 95% CI 0.88 to 0.99, p=0.045). Decreases in pVO2 exceeding 10% were found in 11 (30%) and predicted by lower MG (OR 0.93; 95% CI 0.86 to 0.99, p=0.033).CONCLUSIONS:
Change in pVO2 was heterogeneous. Predictors of favourable and unfavourable outcomes for pVO2 were identified.
Texto completo:
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Bases de dados:
MEDLINE
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
Open Heart
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Dinamarca