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VE_VC02 SLOPE IN HEART FAILURE PATIENTS DUE TO CHAGAS DISEASE IS AN INDEPENDENT PREDICTOR OF LONGTERM MORTALITY
E1938 JACC March 27, 2012 Volume 59, Issue 13
Diagnostic Testing: ECG Exercise and Sports VE_VCO2 SLOPE IN HEART FAILURE PATIENTS DUE TO CHAGAS DISEASE IS AN INDEPENDENT PREDICTOR OF LONGTERM MORTALITY ACC Moderated Poster Contributions McCormick Place South, Hall A Sunday, March 25, 2012, 9:30 a.m.-10:30 a.m.
Session Title: Does the Exercise ECG Have a Role in 2012? Abstract Category: 25. Diagnostic Testing: ECG Exercise Presentation Number: 1155-456 Authors: Luiz Eduardo Fonteles Ritt, Antonio C. Carvalho, Gilson Feitosa, Cristiano Macedo, Fabio Vilas-Boas Pinto, Gilson Feitosa-Filho, Joel pinho, Renato Lopes, Sao Paulo Federal University, Sao Paulo, Brazil, Santa Izabel Hospital, Salvador, Brazil Background: Cardiopulmonary exercise test (CPET) is an established tool to assess prognosis in patients with heart failure (HF). Its prognostic value in patients with HF due to Chagas disease has not yet been determined. Methods: In 55 HF patients due to Chagas disease, CPET were performed and peak VO2, VO2 at anaerobic threshold, VE/VCO2 slope, oxygen uptake efficiency slope (OUES), and O2 pulse were determined. Physical exam, ECG and laboratory test were also performed. Median follow up was 28 months. Results: Patients were well distributed among New York Heart Association classes II-IV. Patients were reasonably well medicated with 89% taking angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, 62% using beta-blockers, 86% using diuretics, and 74% using aldosterone receptor blockers. Mean values for age, peak VO2, VE/VCO2 slope, O2 pulse, OUES and EF were respectively: 52 ± 10 years; 17.3 ± 6.2 ml/kg/min; 36 ± 10; 9.4 ± 3.5 ml/beat; 0.66 ± 0.27 L/min and 27.6 ± 6.6%. The threshold that better combined sensitivity and specificity for VE/ VCO2 slope was 32.5 (sensitivity 72% and specificity 69%). After adjustment, VE/VCO2 slope > 32.5 remained significantly associated with higher mortality (adj. HR 2.3; 95%CI: 1.1-4.7) (Figure). Conclusions: In HF patients due to Chagas disease, the best threshold for VE/VCO2 slope seems to be lower than for other HF etiologies. VE/VCO2 slope > 32.5 assessed by CPET was an independent predictor of long-term mortality. Validation of our findings is needed.
Diagnostic Testing: ECG Exercise and Sports VE_VCO2 SLOPE IN HEART FAILURE PATIENTS DUE TO CHAGAS DISEASE IS AN INDEPENDENT PREDICTOR OF LONGTERM MORTALITY ACC Moderated Poster Contributions McCormick Place South, Hall A Sunday, March 25, 2012, 9:30 a.m.-10:30 a.m.
Session Title: Does the Exercise ECG Have a Role in 2012? Abstract Category: 25. Diagnostic Testing: ECG Exercise Presentation Number: 1155-456 Authors: Luiz Eduardo Fonteles Ritt, Antonio C. Carvalho, Gilson Feitosa, Cristiano Macedo, Fabio Vilas-Boas Pinto, Gilson Feitosa-Filho, Joel pinho, Renato Lopes, Sao Paulo Federal University, Sao Paulo, Brazil, Santa Izabel Hospital, Salvador, Brazil Background: Cardiopulmonary exercise test (CPET) is an established tool to assess prognosis in patients with heart failure (HF). Its prognostic value in patients with HF due to Chagas disease has not yet been determined. Methods: In 55 HF patients due to Chagas disease, CPET were performed and peak VO2, VO2 at anaerobic threshold, VE/VCO2 slope, oxygen uptake efficiency slope (OUES), and O2 pulse were determined. Physical exam, ECG and laboratory test were also performed. Median follow up was 28 months. Results: Patients were well distributed among New York Heart Association classes II-IV. Patients were reasonably well medicated with 89% taking angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, 62% using beta-blockers, 86% using diuretics, and 74% using aldosterone receptor blockers. Mean values for age, peak VO2, VE/VCO2 slope, O2 pulse, OUES and EF were respectively: 52 ± 10 years; 17.3 ± 6.2 ml/kg/min; 36 ± 10; 9.4 ± 3.5 ml/beat; 0.66 ± 0.27 L/min and 27.6 ± 6.6%. The threshold that better combined sensitivity and specificity for VE/ VCO2 slope was 32.5 (sensitivity 72% and specificity 69%). After adjustment, VE/VCO2 slope > 32.5 remained significantly associated with higher mortality (adj. HR 2.3; 95%CI: 1.1-4.7) (Figure). Conclusions: In HF patients due to Chagas disease, the best threshold for VE/VCO2 slope seems to be lower than for other HF etiologies. VE/VCO2 slope > 32.5 assessed by CPET was an independent predictor of long-term mortality. Validation of our findings is needed.