Exercise oscillatory ventilation and prognosis in heart failure patients with reduced and mid-range ejection fraction

被引：28

作者：

Rovai, Sara ^{[1
,2
]}

Corra, Ugo ^{[3
]}

Piepoli, Massimo ^{[4
]}

Vignati, Carlo ^{[1
,31
]}

Salvioni, Elisabetta ^{[1
]}

Bonomi, Alice ^{[1
]}

Mattavelli, Irene ^{[1
]}

Arcari, Luca ^{[5
]}

Scardovi, Angela B. ^{[5
]}

Filardi, Pasquale Perrone ^{[6
]}

Lagioia, Rocco ^{[7
]}

Paolillo, Stefania ^{[6
]}

Magri, Damiano ^{[8
]}

Limongelli, Giuseppe ^{[9
]}

Metra, Marco ^{[10
]}

Senni, Michele ^{[11
]}

Scrutinio, Domenico ^{[4
]}

Raimondo, Rosa ^{[12
]}

Emdin, Michele ^{[13
,14
]}

Lombardi, Carlo ^{[10
]}

Cattadori, Gaia ^{[15
]}

Parati, Gianfranco ^{[16
,17
]}

Re, Federica ^{[18
]}

Cicoira, Mariantonietta ^{[19
]}

Villani, Giovanni Q. ^{[4
]}

Mina, Chiara ^{[20
]}

Correale, Michele ^{[21
]}

Frigerio, Maria ^{[22
]}

Perna, Enrico ^{[22
]}

Mapelli, Massimo ^{[1
]}

Magini, Alessandra ^{[1
]}

Clemenza, Francesco ^{[20
]}

Bussotti, Maurizio ^{[23
]}

Battaia, Elisa ^{[24
]}

Guazzi, Marco ^{[25
]}

Bandera, Francesco ^{[25
]}

Badagliacca, Roberto ^{[26
]}

Di Lenarda, Andrea ^{[27
,28
]}

Pacileo, Giuseppe ^{[9
]}

Maggioni, Aldo ^{[29
]}

Passino, Claudio ^{[13
,14
]}

Sciomer, Susanna ^{[26
]}

Sinagra, Gianfranco ^{[28
,30
]}

Agostoni, Piergiuseppe ^{[1
,31
]}

Apostolo, Anna ^{[32
]}

Palermo, Pietro ^{[32
]}

Contini, Mauro ^{[32
]}

Farina, Stefania ^{[32
]}

Mantegazza, Valentina ^{[32
]}

Spadafora, Emanuele ^{[32
]}

机构：

[1] IRCCS, Ctr Cardiol Monzino, UO Scompenso, Milan, Italy

[2] Univ Padua, Dept Med, Sport & Exercise Med Div, Padua, Italy

[3] Veruno Inst, IRCCS, Ist Clin Sci Maugeri, Cardiol Dept, Veruno, Italy

[4] Guglielmo da Saliceto Hosp, UOC Cardiol, Piacenza, Italy

[5] Santo Spirito Hosp, Cardiol Div, Rome, Italy

[6] Federico II Univ Naples, Dept Adv Biomed Sci, Naples, Italy

[7] Inst Cassano Murge, S Maugeri Fdn, IRCCS, Div Cardiol, Bari, Italy

[8] Sapienza Univ Roma, Azienda Osped St Andrea, Dept Clin & Mol Med, Rome, Italy

[9] Seconda Univ Napoli, Osped Monaldi Azienda Colli, Cardiol SUN, Naples, Italy

[10] Univ Brescia, Dept Med & Surg Specialties Radiol Sci & Publ Hlt, Cardiol, Brescia, Italy

[11] Azienda Osped Papa Giovanni XXIII, Heart Failure & Heart Transplant Unit, Dept Cardiol, Bergamo, Italy

[12] Ist Sci Tradate, IRCCS, Fdn Salvatore Maugeri, Div Cardiol Riabilitat, Tradate, Italy

[13] CNR Reg Toscana, Fdn Gabriele Monasterio, UOC Cardiol & Med Cardiovasc, Pisa, Italy

[14] Scuola Super Sant Anna, Life Sci Inst, Pisa, Italy

[15] Multimed IRCCS, Unita Operat Cardiol Riabilitat, Milan, Italy

[16] Univ Milano Bicocca, Dept Med & Surg, Milan, Italy

[17] San Luca Hosp, Ist Auxol Italiano, Dept Cardiovasc Neural & Metab Sci, Milan, Italy

[18] San Camillo Forlanini Hosp, Cardiac Arrhythmia Ctr, Cardiol Div, Cardiomyopathies Unit, Rome, Italy

[19] Univ Verona, Dept Med, Sect Cardiol, Verona, Italy

[20] IRCCS ISMETT, Dept Treatment & Study Cardiothorac Dis & Cardiot, Palermo, Italy

[21] Univ Foggia, Dept Cardiol, Foggia, Italy

[22] Osped Ca Granda AO Niguarda, Dipartimento Cardiol A De Gasperis, Milan, Italy

[23] Sci Inst Milan, IRCCS, Fdn Salvatore Maugeri, Cardiac Rehabil Unit, Milan, Italy

[24] Santa Chiara Hosp, Dept Cardiol, Trento, Italy

[25] IRCCS Policlin San Donato, Cardiol Univ Dept, Heart Failure Unit & Cardiopulm Lab, San Donato Milano, Italy

[26] Sapienza Rome Univ, Dipartimento Sci Cardiovasc Resp Nefrol Anestesio, Rome, Italy

[27] Hlth Author 1, Cardiovasc Ctr, Dept Cardiol, Trieste, Italy

[28] Univ Trieste, Trieste, Italy

[29] ANMCO Res Ctr, Florence, Italy

[30] Osped Riuniti, Cardiovasc Dept, Trieste, Italy

[31] Univ Milan, Cardiovasc Sect, Dept Clin Sci & Community Hlth, Milan, Italy

[32] IRCCS, Ctr Cardiol Monzino, Via Parea 4, I-20138 Milan, Italy

来源：

EUROPEAN JOURNAL OF HEART FAILURE | 2019年 / 21卷 / 12期

关键词：

Exercise oscillatory ventilation; Heart failure with mid-range ejection fraction; Cardiopulmonary exercise test; Prognosis; OXYGEN-CONSUMPTION; KIDNEY INDEXES; MECKI SCORE; PREVALENCE; OUTCOMES; RISK; BORDERLINE; EFFICIENCY; MORTALITY; SELECTION;

D O I：

10.1002/ejhf.1595

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims Exercise oscillatory ventilation (EOV) is a pivotal cardiopulmonary exercise test parameter for the prognostic evaluation of patients with chronic heart failure (HF). It has been described in patients with HF with reduced ejection fraction (<40%, HFrEF) and with HF with preserved ejection fraction (>50%, HFpEF), but no data are available for patients with HF with mid-range ejection fraction (40-49%, HFmrEF). The aim of the study was to evaluate the prognostic role of EOV in HFmrEF patients. Methods and results We analysed 1239 patients with HFmrEF and 4482 patients with HFrEF, enrolled in the MECKI score database, with a 2-year follow-up. The study endpoint was the composite of cardiovascular death, urgent heart transplant, and ventricular assist device implantation. We identified EOV in 968 cases (16% and 17% of cases in HFmrEF and HFrEF, respectively). HFrEF EOV+ patients were significantly older, and their parameters suggested a more severe HF than HFrEF EOV- patients. A similar behaviour was found in HFmrEF EOV+ vs. EOV- patients. Kaplan-Meier analysis, irrespective of ejection fraction, showed that EOV is associated with a worse survival, and that patients with HFrEF and HFmrEF EOV+ had a significantly worse outcome than the EOV- of the same ejection fraction groups. EOV-associated survival differences in HFmrEF patients started after 18 months of follow-up. Conclusion Exercise oscillatory ventilation has a similar prevalence and ominous prognostic value in both HFmrEF and HFrEF patients, indicating a group of patients in need of a more intensive follow-up and a more aggressive therapy. In HFmrEF, the survival curves between EOV+ and EOV- patients diverged only after 18 months.

引用

页码：1586 / 1595

页数：10

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