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 test and sudden cardiac death risk in heart failure with reduced ejection fraction patients
Session:
CO 12 - Cardiologia preventiva/reabilitação
Speaker:
Sofia Jacinto
Congress:
CPC 2021
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.2 Cardiovascular Rehabilitation
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Sofia Jacinto; João Reis; Alexandra Castelo; Pedro Brás; Rita Ilhão Moreira; Tiago Pereira Silva; Ana Timóteo; Rui Soares; Bárbara Teixeira; Rita Teixeira; Rui Cruz Ferreira
Abstract
<p><strong>Introduction and Purpose</strong></p> <p>Several variables obtained from cardiopulmonary exercise testing (CPET) are strong predictors of overall mortality in chronic heart failure (CHF) patients (pts). However, despite the fact that up to 50% of CHF patients die from sudden cardiac death (SCD), it is unknown whether any of these variables predict SCD. Our aim is to determine the ability of CPET-derived variables of predicting SCD in pts with CHF.</p> <p> </p> <p><strong>Methods</strong></p> <p>Retrospective evaluation of adult pts with HFrEF submitted to cardiopulmonary exercise test in a tertiary centre. Patients were followed up for at least 1 year for the primary endpoint of SCD. Pts that died from pump failure or other causes were excluded from analysis. Cox univariate and multivariate regression analysis were used to determine predictors of SCD. The predictive power of several CPET parameters was analysed (area under the curve - AUC). ROC curves were compared using the Hanley and McNeil test.</p> <p> </p> <p><strong>Results</strong></p> <p>CPET was performed in 487 HF pts, of which 72 pts that died from pump failure or other causes were excluded. 21 pts met the primary endpoint during a mean follow-up of 91.4±67 months. These pts presented a higher prevalence of chronic kidney disease (57.9% vs 31.1%, p=0.015), a lower mean natremia (138.4 vs 136.1, p<0.001), were more symptomatic (42.9% were in NYHA Class III-IV as opposed to 23.6% in the survivors group) and had a lower heart failure survival score (8.19% vs 8.71%, p=0.030) and LVEF (23.4% vs 30.5%, p<0.001) compared to subjects who didn't experience arrhythmic deaths. Interestingly there was no difference in age (58.9 vs 55.5, p=0.226) nor in the prevalence of atrial fibrillation (p=0.293) or ischemic cardiomiopathy (p=0.282). There was no statistically significant difference in the peak oxygen consumption (pVO2 - 16.5 vs 18.6,p=0.074). Several CPET parameters were predictors of SCD, but the one with the highest predictive value was the cardiopulmonary optimal point (VE/VO2), which was significantly higher than the one of pVO2 (AUC of 0.883 vs0.599, p=0.048). A VE/VO2 cut-off of 32.45 had a 100% sensitivity and 75% specificity for the occurrence of SCD, with pts above this value presenting a significantly higher incidence of SCD (log rank p=0.006). Both natremia (HR 0.86, 0.75-0.98, p=0.026) and LVEF (HR 0.91. 0.86-0.97, p=0.002) were independent predictors of SCD. Beta blockers use was associated with a protective effect regarding SCD.</p> <p> </p> <p><strong>Conclusion</strong></p> <p>VE/VO2 has a high predictive value for SCD in patients with CHF and might be an additional tool for prioritization of antiarrhythmic strategies.</p>
Our mission: To reduce the burden of cardiovascular disease
Visit our site