Format

Send to

Choose Destination
See comment in PubMed Commons below
Chest. 2002 May;121(5):1581-8.

Prognostic power of ventilatory responses during submaximal exercise in patients with chronic heart disease.

Author information

1
Cardiovascular Institute, Tokyo, Japan. koike@cepp.ne.jp

Abstract

BACKGROUND:

Although parameters obtained during submaximal exercise are known to be useful for predicting mortality in cardiac patients, it has been a matter of debate whether the submaximal parameters are superior to peak oxygen uptake (VO(2)). For this purpose, we aimed to determine the best index among exercise variables in predicting long-term mortality in patients with chronic heart disease.

METHODS:

The study population consisted of 385 consecutive patients with chronic heart disease who performed a symptom-limited incremental exercise test on a cycle ergometer. Breath-by-breath respiratory gas analysis was used to estimate the peak VO(2), the ratio of the increase in VO(2) to the increase in work rate (WR) [VO(2)/Delta WR], and the ratio of the increase in minute ventilation E to the increase in carbon dioxide output (VCO(2)) [Delta VE/Delta VCO(2)].

RESULTS:

After 1,899 +/- 495 days of follow-up (mean +/- SD), 33 cardiovascular-related deaths occurred. Nonsurvivors achieved lower peak VO(2), lower VO(2)/Delta VWR, and higher Delta VE/Delta VCO(2) compared to the survivors. In the univariate Cox proportional hazards analysis, peak VO(2), VO(2)/Delta VWR, and Delta VE/Delta VCO(2) were found to be significant prognostic indexes of survival. However, multivariate analysis revealed O(2)/Delta VWR as an independent predictor of mortality and Delta VE/delta VCO(2) as a slightly weaker predictor. In this analysis, the prognostic power of peak O(2) was insignificant.

CONCLUSION:

Submaximal respiratory gas indexes are very likely to be more sensitive than peak VO(2) for predicting poor survival in ambulatory patients with chronic heart disease.

PMID:
12006447
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center