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Cardiovascular Death Risk in Recovered Mid-Range Ejection Fraction Heart Failure: Insights From Cardiopulmonary Exercise Test

Authors :
Magrì, D
Piepoli, M
Corrà, U
Gallo, G
Maruotti, A
Vignati, C
Salvioni, E
Mapelli, M
Paolillo, S
Perrone Filardi, P
Girola, D
Metra, M
Scardovi, A
Lagioia, R
Limongelli, G
Senni, M
Scrutinio, D
Emdin, M
Passino, C
Lombardi, C
Cattadori, G
Parati, G
Cicoira, M
Correale, M
Frigerio, M
Clemenza, F
Bussotti, M
Guazzi, M
Badagliacca, R
Sciomer, S
DI Lenarda, A
Maggioni, A
Sinagra, G
Volpe, M
Agostoni, P
MagrÌ D
Piepoli M
CorrÀ U
Gallo G
Maruotti A
Vignati C
Salvioni E
Mapelli M
Paolillo S
Perrone Filardi P
Girola D
Metra M
Scardovi AB
Lagioia R
Limongelli G
Senni M
Scrutinio D
Emdin M
Passino C
Lombardi C
Cattadori G
Parati G
Cicoira M
Correale M
Frigerio M
Clemenza F
Bussotti M
Guazzi M
Badagliacca R
Sciomer S
DI Lenarda A
Maggioni A
Sinagra G
Volpe M
Agostoni P
Magrì, D
Piepoli, M
Corrà, U
Gallo, G
Maruotti, A
Vignati, C
Salvioni, E
Mapelli, M
Paolillo, S
Perrone Filardi, P
Girola, D
Metra, M
Scardovi, A
Lagioia, R
Limongelli, G
Senni, M
Scrutinio, D
Emdin, M
Passino, C
Lombardi, C
Cattadori, G
Parati, G
Cicoira, M
Correale, M
Frigerio, M
Clemenza, F
Bussotti, M
Guazzi, M
Badagliacca, R
Sciomer, S
DI Lenarda, A
Maggioni, A
Sinagra, G
Volpe, M
Agostoni, P
MagrÌ D
Piepoli M
CorrÀ U
Gallo G
Maruotti A
Vignati C
Salvioni E
Mapelli M
Paolillo S
Perrone Filardi P
Girola D
Metra M
Scardovi AB
Lagioia R
Limongelli G
Senni M
Scrutinio D
Emdin M
Passino C
Lombardi C
Cattadori G
Parati G
Cicoira M
Correale M
Frigerio M
Clemenza F
Bussotti M
Guazzi M
Badagliacca R
Sciomer S
DI Lenarda A
Maggioni A
Sinagra G
Volpe M
Agostoni P
Publication Year :
2020

Abstract

Background: Heart failure with midrange ejection fraction (HFmrEF) represents a heterogeneous category where phenotype, as well as prognostic assessment, remains debated. The present study explores a specific HFmrEF subset, namely those who recovered from a reduced EF (rec-HFmrEF) and, particularly, it focuses on the possible additive prognostic role of cardiopulmonary exercise testing. Methods and Results: We analyzed data from 4535 patients with HFrEF and 1176 patients with rec-HFmrEF from the Metabolic Exercise combined with Cardiac and Kidney Indexes database. The end point was cardiovascular death at 5 years. The median follow-up was 1343 days (25th–75th range 627–2403 days). Cardiovascular death occurred in 552 HFrEF and 61 rec-HFmrEF patients. The multivariate analysis confirmed an independent role of the MECKI score's variables in HFrEF (C-index = 0.744) whereas, in the rec-HFmrEF group, only age and peak oxygen uptake (pVO2) remained associated to the end point (C-index = 0.745). A peak oxygen uptake of ≤55% of predicted and a ventilatory efficiency of ≥31 resulted as the most accurate cut-off values in the outcome prediction. Conclusions: Present data support the cardiopulmonary exercise test and, particularly, the peak oxygen uptake, as a useful tool in the rec-HFmrEF prognostic assessment. A peak VO2 of ≤55% predicted and ventilatory efficiency of ≥31 might help to identify a high-risk rec-HFmrEF subgroup.

Details

Database :
OAIster
Notes :
STAMPA, English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1320814057
Document Type :
Electronic Resource