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HEART-RATE RECOVERY AND PEAK EXERCISE OXYGEN CONSUMPTION DURING TREADMILL TESTING PREDICT MORTALITY IN SYSTOLIC HEART FAILURE PATIENTS
E667 JACC March 12, 2013 Volume 61, Issue 10
Heart Failure Heart-Rate Recovery and Peak Exercise Oxygen Consumption during Treadmill Testing Predict Mortality in Systolic Heart Failure Patients Oral Contributions South, Room 102 Sunday, March 10, 2013, 9:15 a.m.-9:30 a.m.
Session Title: Cardiac Transplantation and Mechanical Support Abstract Category: 15. Heart Failure: Clinical Presentation Number: 915-8 Authors: Lee Moschler Pierson, Leslie Cho, Cleveland Clinic Foundation, Cleveland, OH, USA Background: Peak exercise oxygen consumption (PkVO2) is used to estimate prognosis in patients with systolic heart failure (HF). Exercise parameters such as ventilatory threshold (VT), heart-rate recovery (HRR), and chronotropic response index (CRI) may add prognostic information in this population. Methods: We studied 4381 patients (age 54 ± 12 years, 27% female) with systolic HF (ejection fraction 21.9 ± 8.8%, 40% ischemic etiology) who underwent cardiopulmonary stress testing and were followed for a median of 11.3 years. HRR was defined as peak exercise HR minus 2 minute recovery HR and coded abnormal if <12 beats/min. CRI was calculated as [peak HR-rest HR/(220-age -rest HR)] and coded abnormal if < 0.62 if on beta-blocker or <0.8 if no beta-blocker. After univariate analysis, a stepwise multiple logistic regression analysis was used to identify predictors of mortality. Age, gender, ejection fraction, and beta-blockers were included as potential predictors. Results: PkVO2 and VT were 17 ± 6 and 12 ± 4 ml/kg/min respectively. Abnormal values for HRR and CRI were present in 56% and 62% of patients respectively. In univariate analyses, there was a significant difference between patients who lived and died (p<0.001) for all variables studied. Stepwise multivariate logistic regression analyses are shown in table. Conclusions: In patients with systolic HF undergoing stress testing, HRR adds prognostic information to PkVO2, while VT and CRI do not. This holds true for ischemic and non-ischemic HF etiology.
Heart Failure Heart-Rate Recovery and Peak Exercise Oxygen Consumption during Treadmill Testing Predict Mortality in Systolic Heart Failure Patients Oral Contributions South, Room 102 Sunday, March 10, 2013, 9:15 a.m.-9:30 a.m.
Session Title: Cardiac Transplantation and Mechanical Support Abstract Category: 15. Heart Failure: Clinical Presentation Number: 915-8 Authors: Lee Moschler Pierson, Leslie Cho, Cleveland Clinic Foundation, Cleveland, OH, USA Background: Peak exercise oxygen consumption (PkVO2) is used to estimate prognosis in patients with systolic heart failure (HF). Exercise parameters such as ventilatory threshold (VT), heart-rate recovery (HRR), and chronotropic response index (CRI) may add prognostic information in this population. Methods: We studied 4381 patients (age 54 ± 12 years, 27% female) with systolic HF (ejection fraction 21.9 ± 8.8%, 40% ischemic etiology) who underwent cardiopulmonary stress testing and were followed for a median of 11.3 years. HRR was defined as peak exercise HR minus 2 minute recovery HR and coded abnormal if <12 beats/min. CRI was calculated as [peak HR-rest HR/(220-age -rest HR)] and coded abnormal if < 0.62 if on beta-blocker or <0.8 if no beta-blocker. After univariate analysis, a stepwise multiple logistic regression analysis was used to identify predictors of mortality. Age, gender, ejection fraction, and beta-blockers were included as potential predictors. Results: PkVO2 and VT were 17 ± 6 and 12 ± 4 ml/kg/min respectively. Abnormal values for HRR and CRI were present in 56% and 62% of patients respectively. In univariate analyses, there was a significant difference between patients who lived and died (p<0.001) for all variables studied. Stepwise multivariate logistic regression analyses are shown in table. Conclusions: In patients with systolic HF undergoing stress testing, HRR adds prognostic information to PkVO2, while VT and CRI do not. This holds true for ischemic and non-ischemic HF etiology.