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VO2 recovery delay is a useful predictor for impaired recovery of left ventricular function in heart failure with reduced ejection fraction

Session Poster Session 3

Speaker Kyeong-Hyeon Chun

Congress : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Heart Failure with Reduced Ejection Fraction
  • Session type : Poster Session
  • FP Number : P1567

Authors : K Chun (Seoul,KR), BJ Kim (Busan,KR), JW Oh (Seoul,KR), SM Kang (Seoul,KR)

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Authors:
K Chun1 , BJ Kim2 , JW Oh1 , SM Kang1 , 1Yonsei University College of Medicine, Severance Cardiovascular Hospital - Seoul - Korea (Republic of) , 2Kosin University School of Medicine, Cardiology Division - Busan - Korea (Republic of) ,

Citation:

Background: The pattern of VO2 recovery following exercise reflects cardiovascular response, related to the prognosis of heart failure (HF). We aimed to assess the VO2RD as a useful predictor for impaired recovery of left ventricular function (RLVF) in HFrEF.

Method: We investigated pts with HFrEF (EF =45%) who underwent cardiopulmonary exercise test (CPET). All CPET was performed VO2RD was defined as time until post-exercise VO2 falls permanently below peak VO2. We defined impaired RLVF as decreased EF or improvement in EF <10 %, RLVF as improvement in EF =10 % during follow-up period (median 16.5 months).

Result: Total 55 pts with HFrEF (mean 55.0 years old, 78.2% male, 20.0% ischemic) were included. We found 30 pts (54.5%) of impaired RLVF. In terms of baseline characteristics, there were no differences in age, sex, NT-proBNP level, NYHA class and baseline EF between 2 groups. There was significantly different in VO2RD between 2 groups (14.5±11.4 for RLVF group vs. 24.4±19.8 sec for impaired RLVF group, p=0.031). Multivariate regression analysis revealed VO2RD was an independent predictor for impaired RLVF (OR=1.055, p=0.021) when controlled for age, ischemic heart disease and EF. And the cut-off value of VO2RD > 30 sec was associated with impaired RLVF with sensitivity 30.0 % and specificity 96.0 % (ROC area under curve of 0.653, p=0.038).

Conclusion: Post-exercise VO2RD, reflecting impaired cardiac output augmentation may be a useful parameter to predict impaired RLVF in patients with HFrEF.

Recovered group

(N=25)

Non-recovered group

(N=30)

p-value

Pre SPO2

97.3 ± 1.7

97.3 ± 1.2

0.917

Post SPO2

97.2 ± 1.6

97.9 ± 1.2

0.173

Exercise time

10.9 ± 3.6

10.8 ± 3.8

0.936

METs

6.1 ± 1.7

6.4 ± 1.9

0.657

VE/VCO2 slope

30.9 ± 7.8

30.6 ± 5.9

0.868

Peak HR

153.3 ± 32.6

150.3 ± 34.9

0.744

HR at recovery 1min

131.6 ± 28.3

126.0 ± 28.2

0.473

HR at recovery 5min

101.7 ± 22.8

93.8 ± 18.9

0.167

Peak VO2

22.3 ± 6.5

22.2 ± 7.0

0.328

VO2 at recovery 1min

1051.7 ± 438.1

1050.8 ± 312.9

0.993

VO2 at recovery 5min

407.9 ± 158.6

432.1 ± 123.1

0.527

VO2 recovery delay, sec

14.5 ± 11.4

24.4 ± 19.8

0.031

Peak VCO2

1746.2 ± 896.9

1735.8 ± 734.9

0.973

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