Development of a Ventilatory Classification System in Patients With Heart Failure
- 8 May 2007
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 115 (18), 2410-2417
- https://doi.org/10.1161/circulationaha.107.686576
Abstract
Background— Ventilatory efficiency, commonly assessed by the minute ventilation (V̇ e )–carbon dioxide production (V̇ co 2 ) slope, is a powerful prognostic marker in the heart failure population. The purpose of the present study is to refine the prognostic power of the V̇ e /V̇ co 2 slope by developing a ventilatory class system that correlates V̇ e /V̇ co 2 cut points to cardiac-related events. Methods and Results— Four hundred forty-eight subjects diagnosed with heart failure were included in this analysis. The V̇ e /V̇ co 2 slope was determined via cardiopulmonary exercise testing. Subjects were tracked for major cardiac events (mortality, transplantation, or left ventricular assist device implantation) for 2 years after cardiopulmonary exercise testing. There were 81 cardiac-related events (64 deaths, 10 heart transplants, and 7 left ventricular assist device implantations) during the 2-year tracking period. Receiver operating characteristic curve analysis revealed the overall V̇ e /V̇ co 2 slope classification scheme was significant (area under the curve: 0.78 [95% CI, 0.73 to 0.83], P P Conclusions— A multiple-level classificatory system based on exercise V̇ e /V̇ co 2 slope stratifies the burden of risk for the entire spectrum of heart failure severity. Application of this classification is therefore proposed to improve clinical decision making in heart failure.This publication has 27 references indexed in Scilit:
- Impact of time past exercise testing on prognostic variables in heart failureInternational Journal of Cardiology, 2006
- Prognostic characteristics of cardiopulmonary exercise testing in heart failure: comparing American and European modelsEuropean Journal of Preventive Cardiology, 2005
- Improvement of alveolar-capillary membrane diffusing capacity with exercise training in chronic heart failureJournal of Applied Physiology, 2004
- Prognostic Impact of Plasma N-Terminal Pro–Brain Natriuretic Peptide in Severe Chronic Congestive Heart FailureCirculation, 2004
- Peak VO2 and VE/VCO2 slope in patients with heart failure: a prognostic comparisonAmerican Heart Journal, 2004
- Normalization for peak oxygen uptake increases the prognostic power of the ventilatory response to exercise in patients with chronic heart failureAmerican Heart Journal, 2003
- ACC/AHA/ASE 2003 Guideline Update for the Clinical Application of Echocardiography: Summary ArticleCirculation, 2003
- Contribution of peak respiratory exchange ratio to peak VO2 prognostic reliability in patients with chronic heart failure and severely reduced exercise capacityAmerican Heart Journal, 2003
- Predicting Peak Oxygen Consumption During a Conservative Ramping ProtocolJournal of Cardiopulmonary Rehabilitation, 2003
- Ventilatory response to exercise correlates with impaired heart rate variability in patients with chronic congestive heart failureThe American Journal of Cardiology, 1998