Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Cardiopulmonary exercise testing in the age of new heart failure therapies: Still a powerful tool?
Session:
Painel 1 -Insuficiencia cardiaca 3
Speaker:
Pedro Brás
Congress:
CPC 2020
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.3 Chronic Heart Failure – Diagnostic Methods
Session Type:
Posters
FP Number:
---
Authors:
Pedro Garcia Brás; António Valentim Gonçalves; João Pedro Reis; Tiago Pereira Da Silva; Pedro Rio; Rita Ilhão Moreira; Alexandra Castelo; Vera Ferreira; Sofia Silva; Carina Martins; Sónia Coito; Eunice Capilé; Rui M. Soares; Rui Cruz Ferreira
Abstract
<p>Introduction: Cardiopulmonary exercise testing (CPET) is an important exam for risk stratification in chronic heart failure (CHF) patients, including the decision for heart transplantation. With the introduction of new therapies with prognostic benefit such as SLGT2 inhibitors, IV iron, Mitraclip or sacubitril-valsartan and the improvement of the HF care, there is no recent evidence on the prognostic power of CPET parameters in this new subset of patients.</p> <p>The aim of this study was to evaluate the prognostic difference of CPET parameters in patients submitted to CPET before and after 2014.</p> <p>Methods: Retrospective evaluation of patients with CHF submitted to CPET in a tertiary center. Patients were followed up for 12, 24 and 36 months for the composite endpoint of cardiac death, urgent heart transplantation or LVAD. Peak oxygen consumption (pVO2) and VE/VCO2 slope were analysed and their predictive power was compared (area under the curve (AUC)) between 2 groups: patients submitted to CPET before (group A) or after (group B) 2014 (group A). HF events were stratified according to cut-off values defined by the International Society for Heart and Lung Transplantation (ISHLT) guidelines: pVO2 of ≤ 12 mL/Kg/min and VE/VCO2 slope of > 35.</p> <p>Results: CPET was performed in 487 patients (283 patients in group A, 204 patients in group B). Group B patients were older (54±12 vs. 59±13, p=0.002) and had a higher left ventricular ejection fraction (28±8 vs 33±8, p<0.001), with no significant differences in gender (76% vs 86% male) and Heart Failure Survival Score (HFSS 8.7±1.0 vs 8.6±1.3, p=0.494)</p> <p>In patients with pVO<sub>2</sub> ≤ 12, Group A had a significant higher number of the composite endpoint at 12 months (47% vs 2%, p<0.001) and 24 months (53% vs 18%, p=0.02)</p> <p>At 24 months, pVO<sub>2</sub> value of ≤ 12 mL/Kg/min had a positive predictive power of 53% in group A and 18% in group B.</p> <p>Regarding V<sub>E</sub>/V<sub>CO2</sub> slope >35, the group A had also a significant higher number of the composite endpoint at 12 months (29% vs 2%, p<0.001), 24 months (39% vs 13%, p=0.001) and 36 months (46% vs 24%, p=0.037).</p> <p>At 24 months, V<sub>E</sub>/V<sub>CO2</sub> slope value of >35 had a positive predictive power of 39% in group A and 13% in group B.</p> <p>Conclusion: In patients with recent HF therapies there was a significant reduction in the occurrence of major cardiac events. ISHLT guideline established cut-off values for pVO<sub>2</sub> and V<sub>E</sub>/V<sub>CO2</sub> slope had significantly less prognostic power in this group of patients, which suggests that a revision of cut-off values may be needed.</p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site