SPC365

Peak circulatory power is a strong prognostic factor in patients undergoing cardiac rehabilitation

Session: CO 12 - Cardiologia preventiva/reabilitação
Speaker: Bárbara Lacerda Teixeira

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: Bárbara Lacerda Teixeira; João Reis; Alexandra Castelo; Pedro Rio; Sofia Silva; Rita Teixeira; Sofia Jacinto; Rui Cruz Ferreira
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Introduction</span></span></strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Peak circulatory power (PCP - peak oxygen uptake &times; peak systolic blood pressure) is and has been used for the clinical evaluation of patients with heart failure, coronary artery disease and idiopathic pulmonary arterial hypertension, being a strong prognostic factor in these populations.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Purpose</span></span></strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif">To characterize the population of the cardiac rehabilitation (CR) appointment that performed CEPT, evaluate PCP as a predictor of events and determine the best cut off for our population.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Methods</span></span></strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Retrospective analysis of CR appointment patients who performed CEPT between 2014 and 2017 in a single tertiary center. Epidemiological, clinical, laboratory, echo and CEPT-related data were retrieved. We then determined predictors of PCP and established the appropriate Cut Off for our population and compared the occurrence of events - composite endpoint of mortality/ hospitalization due to heart failure (MH) - according to it</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Results</span></span></strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif">207 P (83.6% men) were included, with a mean age of 57 years and a mean follow-up time of 36 months. The Ps presented a mean LVEF of 53.7% (14-83%). The majority (87.9%) was referred for CR with ischemic cardiopathy (AMI or stable or unstable coronary disease), 9.2% with heart failure and 9.2% with valvulopathy. 6.9% P died from any cause, 33.8% had an hospitalization (78.6% from a cardiovascular reason) and 7.3% presented MH. Mean PCP was 3702.5&plusmn;1974.2 mmHg.ml.kg<sup>&minus;1</sup>min<sup>&minus;1 </sup>(249-23180) and in Ps with heart failure was 1989 as opposed to 3858 in Ps without heart failure. A lower PCP was associated with an age&gt;65 years (p&lt;0.001), female sex (p=0.02), diabetes (p=0.005), previous acute coronary syndrome (p=0.021), LVEF&lt;35% (p&lt;0.001), a higher basal BNP value (CC=0.287, p&lt;0.001), higher VE/VCO2 slope (CC=-0.298, p&lt;0.001) and a more negative basal global longitudinal strain (CC=0.353, p&lt;0.001). Ps with a peak VO2&lt;14ml/min/kg also presented a lower PCP (a peak VO2&lt;14ml/min/kg). Values of PCP below a cut-off of 2924 predict the composite endpoint of MH (HR 28.1, IC [3.66-216.29], p=0.001), with these Ps presenting a 40 months survival of 75.4% comparing to 98.8% in Ps with PCP values above the aforementioned cut-off (log-rank p&lt;0.001). However, that cut-off didn&#39;t correlate with all cause hospitalization, need for further coronary revascularization or cardiac device.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Conclusion</span></span></strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif">PCP was predictor of cardiac events in our population, with Ps with a PCP value&lt;2924 presenting a statistically significant lower survival.</span></span></span></span></span></p>

<p style="text-align:justify">&nbsp;</p>