Recent Findings from the FHS CPET station: June 29, 2020
Clinical and Hemodynamic Associations and Prognostic Implications of Ventilatory Efficiency in Patients With Preserved Left Ventricular Systolic Function
Nayor et al., 2020
What Is New?
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Ventilatory efficiency (VE/VCO2) during exercise potently predicts outcomes in advanced heart failure with reduced ejection fraction.
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In this study, we establish distinct clinical correlates of VE/VCO2 during early and late exercise in a middle-aged community cohort. High VE/VCO2 during early exercise is associated with cardiovascular disease risk.
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The VE/VCO2nadir is associated with adverse hemodynamic profiles and future cardiovascular disease in a dyspneic referral cohort with preserved left ventricular systolic function. Our work highlights the prognostic importance of noninvasive VE/VCO2 measures beyond heart failure with reduced ejection fraction while also indicating that VE/VCO2nadir is the optimal measure of ventilatory efficiency in patients with preserved left ventricular systolic function.
What are the Clinical Implications?
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VE/VCO2 is an easily derived noninvasive measurement during submaximum exercise that closely reflects invasively derived cardiac output, pulmonary artery pressure, and pulmonary capillary wedge pressure during exercise.
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The ability of VE/VCO2 to reflect hemodynamic responses to exercise may be particularly relevant for early detection of HF and pulmonary vascular disease.
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VE/VCO2 has been primarily established as a prognostic variable in advanced heart failure and pulmonary hypertension. Our findings extend its prognostic significance to populations at risk for heart failure with preserved left ventricular systolic function.
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