The Prognostic Value of Peak Cardiac Power Output in Chinese Patients with Chronic Heart Failure.

Yuqin Shen,Haoming Song,Lin Zhou,Lemin Wang,Wenjun Xu,Guanghe Li,Jiahong Xu,Xiaoyu Zhang,Zhu Gong,Wenlin Ma,Jinfa Jiang,Wenwen Yan,Lin Che,Yi Ni,Qiping Zhang,Pasquale Abete

doi:10.1371/journal.pone.0147423

Abstract

BackgroundCardiopulmonary exercise testing has been widely used to risk stratify patients with chronic heart failure (CHF). Peak oxygen consumption (peakVO2) was regarded as a powerful predictor of survival, as it is a surrogate for peak cardiac output (CO), which by most is considered the “true” measure of heart failure. Therefore, it is reasonable to hypothesize that CO is an even stronger predictor than peak VO2. The present study is aimed to investigate the prognostic value of peak cardiac power output (peak CPO) in comparison with peakVO2 in Chinese patients with CHF.MethodsParticipants provided written informed consent to participate in this study. Totally 129 patients with CHF underwent symptom-limited cardiopulmonary exercise testing (CPET), with mean age 59.1±11.4 years, 87.6% male, 57.4% ischemic etiology, body mass index (BMI) 24.7±3.7 kg/m2 and LVEF 38±9%. CO was measured using an inert gas rebreathing method. The primary endpoints are cardiac deaths.ResultsOver median 33.7-month follow-up, 19 cardiac deaths were reported. Among peak VO2,VE/VCO2 slope and Peak CPO, their area under ROC were 0.64, 0.67, 0.68, respectively (Ρ<0.05).The optimal thresholds for predicting cardiac deaths were peak VO2≤13.4 ml.kg-1.min-1, and VE/VCO2 slope≥39.3 and peak CPO≤ 1.1 respectively by ROC analysis. Finally, in patients with a peak VO2≤13.4 ml.kg-1.min-1 those with peak CPO>1.1W had better survival than those with peak CPO ≤ 1.1W. However, by multivariate analysis adjusted for age, sex, BMI, resting heart rate, LVMI, LVEF, Peak CPO was not an independent predictor of cardiac deaths (P> 0.05).ConclusionsPeak CPO was not a predictor of cardiac death in Chinese CHF patients.

Highlights

Low cardiac output (CO) is associated with longer hospital stay, increasing morbidity and mortality
By multivariate analysis adjusted for age, sex, Body mass index (BMI), resting heart rate, LVMI, LVEF, Peak CPO was not an independent predictor of cardiac deaths (P> 0.05)
The experimental protocol was approved by the Ethics Committee of Affiliated Tongji Hospital of Tongji University.Inclusion criteria consisted of a diagnosis of heart failure [4] and evidence of left ventricular systolic dysfunction with LVEF< 50% on 2-dimensional echocardiography obtained within 1 month prior to study

Summary

Background

Cardiopulmonary exercise testing has been widely used to risk stratify patients with chronic heart failure (CHF). Peak oxygen consumption (peakVO2) was regarded as a powerful predictor of survival, as it is a surrogate for peak cardiac output (CO), which by most is considered the “true” measure of heart failure. The present study is aimed to investigate the prognostic value of peak cardiac power output (peak CPO) in comparison with peakVO2 in Chinese patients with CHF. Data Availability Statement: All relevant data are within the paper and its Supporting Information files.

Methods

Results

Introduction

Materials and Methods

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