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Prognostic respiratory parameters in heart failure patients with and without exercise oscillatory ventilation - a systematic review and descriptive meta-analysis.

Session Rapid Fire Abstract Session II - Cardiac Rehabilitation & Exercise Basic & Translational Research

Speaker Justien Cornelis

Event : ESC Preventive Cardiology (Formerly EuroPrevent) 2015

  • Topic : preventive cardiology
  • Sub-topic : Cardiovascular Rehabilitation
  • Session type : Rapid Fire Abstracts

Authors : J Cornelis (Antwerp,BE), J Taeymans (Bern,CH), W Hens (Antwerp,BE), P Beckers (Antwerp,BE), C Vrints (Antwerp,BE), D Vissers (Antwerp,BE)

J Cornelis1 , J Taeymans2 , W Hens1 , P Beckers3 , C Vrints3 , D Vissers1 , 1University of Antwerp, Department of Physiotherapy (REVAKI) - Antwerp - Belgium , 2Bern University of Applied Sciences, Health - Bern - Switzerland , 3University of Antwerp Hospital (Edegem), Department of Cardiology - Antwerp - Belgium ,


Purpose: The purpose of this review was to describe the occurrence of prognostic variables as derived from  cardiopulmonary exercise testing (CPET) in patients with heart failure (HF), presenting exercise oscillatory ventilation (EOV) compared to patients without EOV. The effect of EOV on peak oxygen consumption (VO2), minute ventilation/carbon dioxide production (VE/VCO2) slope, oxygen uptake efficiency slope (OUES), rest and peak pulmonary end-tidal carbon dioxide pressure (PETCO2) was meta-analysed.

Methods: A systematic search strategy was performed in five databases (Pubmed, Cochrane Library, PEDro, Science Direct and Web of Science), assessing 252 articles for eligibility. Nineteen citations met the inclusion criteria totalling 3032 patients with HF (EOV=1111; non-EOV=1921). The risk of bias was assessed by two researchers. Extracted data were pooled using random or fixed effects meta-analysis, if appropriate. The level of significance was set at P =0.05.

Results: Overall, presentation of EOV significantly indicated aggravated prognostic markers. Sub-study analysis revealed left ventricular ejection fraction (LVEF) and mode of CPET protocol as independent factors, whereas defining EOV significantly influenced the results.  A meta-analysis of studies reporting hazard ratios for cardiovascular events demonstrated that HF patients with EOV run a fourfold risk for an adverse event compared to HF patients without EOV.

Conclusions: These findings suggest that the presence of EOV in patients with HF is associated with a deterioration of prognostic CPET parameters. Therefore, EOV could be an important marker in prognosis of patients with HF. Based upon these results, we suggest to include the assessment of EOV in the standard evaluation protocol of cardiopulmonary exercise testing.

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