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Age Differences in Cardiopulmonary Exercise Testing Parameters in Heart Failure with Reduced Ejection Fraction.
- Source :
-
Medicina (Kaunas, Lithuania) [Medicina (Kaunas)] 2023 Sep 20; Vol. 59 (9). Date of Electronic Publication: 2023 Sep 20. - Publication Year :
- 2023
-
Abstract
- Background and Objectives : Cardiopulmonary exercise testing (CPET) is a cornerstone of risk stratification in heart failure with reduced ejection fraction (HFrEF). However, there is a paucity of evidence on its predictive power in older patients. The aim of this study was to evaluate the prognostic power of current heart transplantation (HTx) listing criteria in HFrEF stratified according to age groups. Materials and Methods : Consecutive patients with HFrEF undergoing CPET between 2009 and 2018 were followed-up for cardiac death and urgent HTx. Results : CPET was performed in 458 patients with HFrEF. The composite endpoint occurred in 16.8% of patients ≤50 years vs. 14.1% of patients ≥50 years in a 36-month follow-up. Peak VO <subscript>2</subscript> (pVO <subscript>2</subscript> ), VE/VCO <subscript>2</subscript> slope and percentage of predicted pVO <subscript>2</subscript> were strong independent predictors of outcomes. The International Society for Heart and Lung Transplantation thresholds of pVO <subscript>2</subscript> ≤ 12 mL/kg/min (≤14 if intolerant to β-blockers), VE/VCO <subscript>2</subscript> slope > 35 and percentage of predicted pVO <subscript>2</subscript> ≤ 50% presented a higher overall diagnostic effectiveness in younger patients (≤50 years). Specific thresholds for each age subgroup outperformed the traditional cut-offs. Conclusions : Personalized age-specific thresholds may contribute to an accurate risk stratification in HFrEF. Further studies are needed to address the gap in evidence between younger and older patients.
- Subjects :
- Humans
Aged
Exercise Test
Stroke Volume
Heart
Heart Failure
Heart Transplantation
Subjects
Details
- Language :
- English
- ISSN :
- 1648-9144
- Volume :
- 59
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Medicina (Kaunas, Lithuania)
- Publication Type :
- Academic Journal
- Accession number :
- 37763804
- Full Text :
- https://doi.org/10.3390/medicina59091685