Abstract 2907: Exercise Oscillatory Ventilation Predicts Cardiac Mortality in Heart Failure Patients with Preserved Systolic Function
Background: Exercise oscillatory ventilation (EOV) is a strong prognosticator in heart failure (HF) patients with systolic dysfunction. Our group has demonstrated peak oxygen consumption (VO2) and the minute ventilation (VE)/carbon dioxide production (VCO2) slope maintain prognostic value in HF patients with preserved systolic function (PSF).
Objective: We tested the hypothesis that EOV would maintain pathophysiological and prognostic impact in HF patients with PSF.
Methods: 112 HF patients with PSF (80 males/ 32 females, age: 57.1 +/-13.3 years, ejection fraction: 47.5 +/-7.7%) underwent cardiopulmonary exercise testing with peak VO2, VE/VCO2 slope and EOV determination. EOV was defined as ventilatory oscillatory fluctuations for >60% of exercise test at an amplitude <15% of resting fluctuations. Subjects were tracked for cardiac mortality for three years.
Results: 37 subjects demonstrated EOV during testing. The following unpaired t-test results are presented as EOV vs. no-EOV subgroups. Peak VO2 (12.2 +/-4.2 vs. 17.8+/- 5.5 mlO2/kg/min, p<0.001) was significantly lower while the VE/VCO2 slope (36.6 +/-7.2 vs. 31.7+/-7.1, p<0.001) was significantly higher in the EOV subgroup. There were 10 cardiac-related deaths during the follow-up. EOV was a significant predictor of cardiac-related mortality (HR: 3.8, 95% CI: 1.1–13.5, p=0.04). Kaplan-Meier analysis in illustrated is in Figure⇓. Survival in the no-EOV and EOV subgroups was 94.7% and 83.8%, respectively (Log-rank: 4.9, p=0.02).
Conclusions: EOV maintains prognostic value in HF patients with PSF. It is very likely that EOV presence reflects worsening physiologic function irrespective of ejection fraction.