Does Tricuspid Regurgitation Contribute to Renal Dysfunction in Patients With Heart Failure?

Abstract

Results: There was no morbidity associated with exercise testing. Baseline estimated metabolic equivalents (METs) were 6.1± 3.0 (mean±S.D.) for patients with severe LVD and 7.3± 2.3 for patients with moderate LVD (p< 0.001). Pressure-rate product (PRP;×100) was 147± 44 for severe LVD and 163± 42 for moderate LVD (p< 0.05). During the program, 18 patients were referred to other rehabilitation units. By the end of the 6-week exercisetraining program (ET), 157 patients (62%) completed cardiac rehabilitation out of the remaining 252 eligible patients. The benefits of completed ET were examined by repeat exercise testing. For the 57 patients with severe LVD, METs improved with ET from 6.5± 2.4 to 8.9± 2.9 (p< 0.001), although PRP was unchanged (155± 49 versus 166± 49). For the 100 patients with moderate LVD, METs improved from 7.3± 2.1 to 10.3± 2.6 (p< 0.001), and PRP increased at peak exercise from 156± 47 to 171± 49 (p< 0.01). Conclusions: Stable patients with moderate or severe LVD can achieve reasonable workloads at exercise testing, with a significant improvement in workloads (average 2–3 METs) in patients completing 6 weeks of ET. This in turn would suggest a potential for at least a 26% reduction in mortality based on current data. doi:10.1016/j.hlc.2008.05.336 336 111± 20). For pts with moderate LVD, resting HR did not change during CR (73± 13 vs. 70± 12), and resting systolic BP rose a little from 113± 19 to 117± 21 (p< 0.05). Conclusions: In this cohort of stable pts with moderate to severe LVD, there was a high level of BB and ACE use, especially in pts with severe LVD. The levels observed in this study are congruent with or better than recently presented Australian studies [Driscoll et. al., Bennett et al. Asia-Pacific Congress of Heart Failure; 2008]. Resting HR averaged≥70, implying incomplete beta blockade inmany pts. doi:10.1016/j.hlc.2008.05.337