Clinical InvestigationThe Minute Ventilation/Carbon Dioxide Production Slope is Prognostically Superior to the Oxygen Uptake Efficiency Slope
Section snippets
Methods
This study was a multicenter analysis including patients with HF from the CPET laboratories at Virginia Commonwealth University, Richmond, and the Veterans Administration Palo Alto Health Care System and Stanford University, Palo Alto, California. A total of 341 patients with chronic HF tested between March 18, 1993, and August 28, 2006, were included. Subjects undergoing testing up to 2001 were assessed retrospectively. A prospective research protocol was designed in 2002 to continue to expand
Results
Forty-seven subjects suffered major cardiac events (36 deaths, 9 urgent transplantations, 2 LVAD implantations) during the 3-year tracking period. The annual event rate was 6.4%. Two subjects died of noncardiac causes (both cancer) and were treated as censored cases at the time of their death. All subjects included in the analysis had active charts during the tracking period providing for a high level of confidence that all major cardiac events were captured. Baseline and CPET characteristics
Discussion
An increasing number of CPET variables have demonstrated prognostic value in the HF population. Peak VO2 is the most established, although a number of investigations have found the VE/VCO2 slope is prognostically superior.1, 2, 14 The OUES has also been proposed as a CPET measure of potential clinical value in HF, although evidence supporting its use is limited. The results of the present study indicate that, although the OUES is a significant prognostic marker, the VE/VCO2 slope calculated
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