Abstract 11839: Comparisons of Cardiopulmonary Exercise Testing Between Heart Failure With Reduced Ejection Fraction and Preserved Ejection Fraction
Background: Parameters derived from cardiopulmonary exercise testing (CPET) are important prognostic markers, especially peak oxygen consumption (VO2), the minute ventilation carbon dioxide production slope (VE/VCO2 slope), exertional oscillatory ventilation (EOV) and oxygen uptake efficiency slope (OUES) in chronic heart failure (CHF). However, the significance of these parameters has not been examined in terms of left ventricular ejection fraction (EF). We aimed to compare the impacts of these exercise parameters on clinical outcomes between CHF patients with reduced EF (HFrEF) and preserved EF (HFpEF).
Methods: We analyzed 1190 patients (969 males, mean age 61.0 years) with CHF who admitted to our hospital and performed CPET. We divided subjects into two groups: HFrEF (LVEF<45%, n=655) and HFpEF (LVEF≥45%, n=535). We compared the independent factors to predict adverse composite cardiac events (cardiac deaths and rehospitalization due to worsening heart failure), cardiac deaths and all-cause deaths between HFrHF and HFpEF.
Results: In the follow-up period (mean 1155 days), 407 adverse cardiac events (rehospitalization due to worsening heart failure and cardiac deaths), 172 cardiac deaths and 247 all-cause deaths were occurred. Kaplan-Meier analyses demonstrated that composite cardiac event rates, cardiac and all-cause mortalities were significantly higher in HFrEF than in HFpEF (P<0.001, respectively). In Cox proportional hazard multivariate analyses, independent predictors of composite adverse events were peak VO2, VE/VCO2 slope and OUES in HFrEF (P<0.001, P<0.001 and P=0.001, respectively), those of cardiac deaths were peak VO2, OUES and VE/VO2 slope (P=0.002, P=0.005 and P=0.008, respectively), and those of all-cause deaths were peak VO2, OUES and VE/VCO2 slope (P=0.001 and P=0.023 and P=0.041, respectively) in HFrEF. On the other hands, the independent predictors of composite adverse events were peak VO2 and VE/VCO2 slope (P<0.001 and P=0.041), and those of cardiac deaths and all cause deaths were peak VO2 in HFpEF (P<0.001 and P=0.001, respectively).
Conclusion: Impacts of these parameters were different between HFrEF and HFpEF based on several clinical outcomes.
Author Disclosures: T. Sato: None. Y. Kanno: None. A. Yoshihisa: None. Y. Takeishi: None.
- © 2016 by American Heart Association, Inc.