Prognostic Impact of Ventilatory Efficiency in Heart Disease Patients With Preserved Exercise Tolerance

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Background The minute ventilation/carbon-dioxide output (VE/VCO_2) slope as a marker of cardiac events has been established in patients with severe heart failure, but it is not known whether it is useful for other heart diseases. Methods and Results The present study investigated 215 patients with various heart diseases (age 59±11 years; ischemic heart disease, n=89; dilated cardiomyopathy, n=38; valvular disease, n=37; hypertensive heart disease, n=33; others, n=18) who underwent cardiopulmonary exercise testing to determine the VE/VCO_2 slope. Patients were divided into 2 groups according to the VE/VCO_2 slope and were followed-up for 3 years. Forty-eight cardiac events (6 deaths, 42 re-hospitalizations) occurred during the observation period. Patients with a VE/VCO_2 slope >34 had a significantly higher 3-year cardiac event rate (32.1%) than patients with VE/VCO_2 slope <34 (18.9%, p<0.05). When patients were selected with relatively preserved peak oxygen uptake values (>16ml・kg^<-1>・min^<-1>), patients with VE/VCO_2 slope >34 still demonstrated a significantly higher cardiac event rate than other patients (35.0% vs 13.3%, p<0.01). Conclusion The VE/VCO_2 slope may be a prognostic indicator of cardiac events in a heterogeneous group of patients with heart disease, independent of exercise tolerance.
社団法人日本循環器学会の論文
2006-09-20