Prognostic Significance of Cardiopulmonary Exercise Testing for 10-Year Survival in Patients With Mild to Moderate Heart Failure

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概要

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• Although a number of studies have investigated the prognostic significance of exercise variables, they have focused only on short-term prognosis in relatively severe heart failure. This study was carried out to determine whether the indices obtained during cardiopulmonary exercise testing have prognostic significance during a 10-year follow-up in mild to moderate heart failure. Three hundred and sixty-four consecutive patients with cardiac discase performed 4 min of 20-W warm-up, followed by a symptom-limited incremental exercise test on a cycle ergometer. In addition to the measurements of peak oxygen uptake (V^^・O_2) and gas exchange (anaerobic) threshold, the time constant of V^^・O_2 kinetics during the onset of warm-up exercise was calculated using a single exponential equation. Data on mortality were available for follow-up in 260 patients. After 3,331±610 days of follow-up, 29 cardiovascular-related deaths occurred. The time constant of V^^・O_2 in the nonsurvivors was 76.7±43.3s and was significantly prolonged compared with that of survivors (55.3±30.6s, p=0.001). Peak V^^・O_2 and gas exchange threshold were both significantly lower in nonsurvivors than in survivors. Kaplan-Meier survival curves for 10 years of follow-up demonstrated a survival rate of 89.0% for patients with a normal V^^・O_2 time constant (<80s) and 71.7% for those with a longer time constant(>__-80s), showing a significant difference in survival (p=0.0028). Respiratory gas parameters obtained during exercise testing, particularly the time constant of V^^・O_2 kinetics, were found to be useful for predicting long-term prognosis in patients with chronic heart failure. These results suggest that cardiopulmonary exercise testing could be more applicable in ambulatory patients with minimal symptoms or minimal functional impairment.

• 社団法人日本循環器学会の論文
• 2000-11-20

著者

• Itoh Haruki

  Akita University School Of Medicine

• MARUMO FUMIAKI

  Second Department of Internal Medicine, Tokyo Medical and Dental University

• Itoh Haruki

  The Cardiovascular Institute Hospital

• IIMURA Hiroyuki

  The Cardiovascular Institute

• Koike Akira

  The Cardiovascular Institute

• Koike Akira

  心臓血管研究所

• Hirose Makoto

  Division Of Cradiology Heart Institute Chiba-nishi General Hospital

• Hiroe Michiaki

  Department Of Medicine Tokyo Medical And Dental University

• Iinuma Hiroyuki

  鹿児島大学 大学院医歯学総合研究科循環器･呼吸器･代謝内科学

• Koike Akira

  Japanese Cardiac Rehabilitation Research Group (Ministry of Health, Labor, and Welfare 15A-2)

• Itoh Haruki

  The Cardiovascular Institute

• Marumo Fumiaki

  Department Of Nephrology Tokyo Medical And Dental University

• Marumo Fumiaki

  The Second Department Of Medicine Tokyo Medical And Dental University

• Marumo Fumiaki

  Second Department Of Internal Medicine Faculty Of Medicine Tokyo Medical And Dental University

• Hiroe Michiaki

  Second Department of Internal Medicine, Tokyo Medical and Dental University

• Koyama Yoshiharu

  Second Department of Internal Medicine, Tokyo Medical and Dental University

• Adachi Hiromasa

  Hokushin General Hospital

• Itoh Haruki

  Int. Medicine Yokosuka Mutual Aid Hospital.

• KOYAMA Yoshiharu

  Tokyo Kyosai Hospital

• Marumo Fumiaki

  Second Department Of Medicine Tokyo Medical And Dental University

• Hirose Makoto

  The Department Of Nephrology And Cardiology International Medical Center Of Japan

• Itoh Haruki

  Department Of Internal Medicine Chiba Shakai-hoken Hospital

• Hiroe Michiaki

  Second Department Of Internal Medicine Tokyo Medical And Dental University

• Koike Akira

  Department Of Critical Care Medicine Tokyo Medical And Dental University

• Hiroe Michiaki

  Department Of Radiology Tokyo Women's Medical College

• Hiroe Michiaki

  Department Of Nephrology And Cardiology

• Marumo Fumiaki

  Institute Of Geriatrics Department Of Cardiology Department Of Radiology And Departement Of Patholog

• Ito Hiroshi

  Second Department Of Internal Medicine Tokyo Medical And Dental University

• Ito Hiroshi

  Akita University School Of Medicine

• Ito Hiroshi

  Department Of Cardiovascular Medicine Akita University Graduate School Of Medicine

• Marumo Fumiaki

  Institute Of Geriatrics Department Of Cardiology Department Of Radiology And Departement Of Patholog

• Hiroe Michiaki

  Second Department Of Internal Medicine

• Marumo Fumiaki

  Institute Of Geriatrics Department Of Cardiology Department Of Radiology And Departement Of Patholog

• Marumo Fumiaki

  Institute Of Geriatrics Department Of Cardiology Department Of Radiology And Departement Of Pathology Tokyo Women's Medical College The 2nd Department Of Medicine Tokyo Medical And Dental University

• KOIKE Akira

  The Cardiovascular Instirute

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