758–3 Right Ventricular Ejection Fraction is an Independent Predictor of Maximum Oxygen Consumption in Advanced Heart Failure

Abstract

Maximum oxygen consumption (MVO 2 ), left ventricular ejection fraction (LVEF), and left ventricular end-diastolic volume index (LVEDVI) are important determinants of prognosis in heart failure (HF). To determine the ventriculographic parameters influencing MVO 2 , simultaneous cardiopulmonary exercise testing (cycle ergometry) and first-pass rest and exercise radionuclide ventriculography were performed in 66 patients with advanced HF (age 51 ± 9.9 mean ± SD, NYHA 3 ± 0.6, LVEF 0.22 ± 0.07, RVEF 0.29 ± 0.11, LVEDVI 154 ± 49 m1/M 2 ) during initial cardiac transplant evaluation. Mean percent predicted age-sex adjusted MVO 2 achieved (%MVO 2 ) was 38 ± 12%. Univariate predictors of %MVO 2 included RVEF at rest (p = 0.001). RVEF at peak exercise (p = 0.001), %maximum heart rate achieved (%MHR, p < 0.01), LVESVI (p < 0.05). and NYHA (p = 0.05). Resting HR, resting or peak systolic or diastolic blood pressure, resting or peak exercise LVEF, exercise-related rise or fall > 0.05 in either LVEF or RVEF, rest or peak exercise cardiac index, rest or peak exercise LVEDVI, NYHA, and diagnosis were not significant univariate predictors of %MVO 2 . RVEF at rest (p = 0.001) and %MHR (p = (0.01) were the only independent predictors in a multiple linear regression model. In patients with advanced HF, 1) RVEF is an independent predictor of %MVO 2 and 2) neither rest or exercise LVEF predicts %MVO 2 .