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.

Rovai, S., Corra, U., Piepoli, M., Vignati, C., Salvioni, E., Bonomi, A., et al. (2019). Exercise oscillatory ventilation and prognosis in heart failure patients with reduced and mid-range ejection fraction. EUROPEAN JOURNAL OF HEART FAILURE, 21(12), 1586-1595 [10.1002/ejhf.1595].

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

Salvioni E.;Bonomi A.;Mattavelli I.;Senni M.;Raimondo R.;Parati G.;Frigerio M.;Bussotti M.;
2019

Abstract

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.
Articolo in rivista - Articolo scientifico
Cardiopulmonary exercise test; Exercise oscillatory ventilation; Heart failure with mid-range ejection fraction; Prognosis;
Cardiopulmonary exercise test; Exercise oscillatory ventilation; Heart failure with mid-range ejection fraction; Prognosis
English
2019
21
12
1586
1595
none
Rovai, S., Corra, U., Piepoli, M., Vignati, C., Salvioni, E., Bonomi, A., et al. (2019). Exercise oscillatory ventilation and prognosis in heart failure patients with reduced and mid-range ejection fraction. EUROPEAN JOURNAL OF HEART FAILURE, 21(12), 1586-1595 [10.1002/ejhf.1595].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/260350
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