Cardiopulmonary Exercise Measures of Men and Women with HFrEF Differ in Their Relationship to Prognosis: The Henry Ford Hospital Cardiopulmonary Exercise Testing (FIT-CPX) Project.

Background: This study evaluated if different prognostic characteristics exist for peak oxygen consumption (VO ₂ ), percent predicted peak VO ₂ (ppVO ₂ ), and the slope of the change in minute ventilation to volume of carbon dioxide produced (V _E -VCO ₂ ) slope between men and women with heart failure and reduced ejection fraction (HFrEF).
Methods: Analysis of the Henry Ford Hospital Cardiopulmonary Exercise Testing database (n = 1085; 33% women, 55% black) of individuals with HFrEF who completed a physician-referred cardiopulmonary exercise testing (CPX) between 1997 and 2010. Primary outcome was a composite of all-cause death, left ventricular assist device placement, and orthotopic heart transplant . Logistic and Cox regressions were performed and Kaplan-Meier survival curves were developed to describe relationships of the CPX variables and the composite outcome within and between men and women.
Results: All patients were followed-up for a minimum of 5 years, during which there were 643 combined events (62%; 499 deaths, 64 left ventricular assist device implants, 80 orthotopic heart transplant). Each CPX variable was significantly related to event-free survival among both men and women. Log-rank assessment of Kaplan-Meier curves noted survival differences for peak VO ₂ and V _E -VCO ₂ slope (p ≤ .002), but not ppVO ₂ (P = .32), between men and women.
Conclusions: Prognostic values for peak VO ₂ and the V _E -VCO ₂ slope might be considered separately for men and women, whereas the ppVO ₂ value corresponding to 1- and 3-year survival rates may not be different between the sexes.
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