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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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A. Basics
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01. History of Cardiology
02. Clinical Skills
03. Imaging
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05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
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31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
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Cardiorespiratory Optimal Point: A novel cardiopulmonary exercise testing parameter for prognosis in patients with ischaemic heart disease
Session:
Posters 1 - Écran 06 - Reabilitação cardíaca
Speaker:
Tiago Mendonça
Congress:
CPC 2018
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.2 Cardiovascular Rehabilitation
Session Type:
Posters
FP Number:
---
Authors:
Tiago Mendonça; Ana Abreu; Pedro Rio; Guilherme Portugal; Sofia Silva; Rui M. Soares; Rui Cruz Ferreira
Abstract
<p><strong>Purpose</strong>: The cardiorespiratory optimal point (COP), calculated as the minimum VE/VO2 value obtained during cardiopulmonary exercise test (CPET) is a new index, which is not dependent on maximal exercise. COP has been reported as an independent predictor of all-cause mortality in a general population, however the prognostic value in selected groups of patients has not been demonstrated yet. Other variables, like brain-type natriuretic peptide (BNP) are well established prognostic markers. Our aim was to investigate the role of COP in the evaluation of patients with Ischemic Heart Disease, IHD.</p> <p><strong>Methods: </strong>Retrospective analysis of CPET variables in patients with IHD who performed a symptom-limited treadmill CPET, using the modified Bruce protocol. The following parameters were evaluated: age, gender, body max index, peak oxygen consumption (peak VO<sub>2</sub>), VE/VCO<sub>2</sub> slope, exercise capacity, left ventricular ejection fraction (LVEF) by echocardiography, and BNP. We assessed which of these variables in a multivariate linear regression model predicted BNP serum levels.</p> <p><strong>Results: </strong>56 patients, 87.5% male, mean age 55.7±10.8, were analysed. 94% of patients had previous history of myocardial infarction. Mean left ventricular ejection fraction was 54.9±10.7%, mean serum BNP 139.6±196.9 pg/mL, mean peak oxygen consumption (peak VO2) 23.7±4.5 ml/kg/min. COP was correlated with BNP levels (r=0.391, p<0.01), peak VO2 (r =-0.422, p<0.01), VE/VCO2 slope (r=0.351 p=0.01). In multivariate linear regression, the independent predictors of BNP levels were peak VO2 (β=-17.24, 95% CI -27.27 to -7.22, p<0.01), COP (β=12.13, 95% CI 1.25 to 23.02, p=0.03), and LVEF (β=-7.16, 95% CI -11.25 to -3.06, p<0.01).</p> <p><strong>Conclusions: </strong>COP is an independent predictor of BNP serum levels in patients with IHD. This relation indicates, that in IHD patients submitted to CPET, COP may provide a better cardiovascular risk discrimination.</p>
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