Clinical investigation: imaging and diagnostic testingPeak VO2 and VE/VCO2 slope in patients with heart failure: a prognostic comparison
Section snippets
Methods
Two hundred thirteen subjects, assessed between April 1, 1993, and October 19, 2001, were included in the study. One hundred forty-four subjects underwent exercise testing and were subsequently observed at the Veterans Hospital in Palo Alto, Calif. The remaining 69 subjects were tested and observed in the heart failure program at the Virginia Commonwealth University Medical Center in Richmond. All subjects underwent tested on an outpatient basis. The exercise tests were conducted as part of the
Results
The mean follow-up period was 32 ± 26 months, and the annual mortality rate was 5.4%. Mean values for peak VO2 and VE/VCO2 slope were 16.3 ± 6.0 mL × kg−1 × min−1 and 33.2 ± 7.9 mL × kg−1 × min−1, respectively. On the basis of individual peak VO2 values, the Weber classification for the group was: Weber class A, 51; Weber class B, 47; Weber class C, 89; Weber class D, 26. There were 15 cardiac-related deaths and 61 cardiac-related hospitalizations within 1-year after exercise testing. Overall,
Discussion
The results of this study add to a growing body of data demonstrating the prognostic value of peak VO2 and VE/VCO2 slope in the HF population.3, 8, 9, 10, 11, 12, 13 More importantly, these results support the concept that the VE/VCO2 slope is prognostically superior to peak VO2, an observation made recently by other investigators, although not overly emphasized.3, 8, 10, 11, 14
There may be several reasons for the differences between the prognostic value of the VE/VCO2 slope and peak VO2. Peak
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