Key result
Cardiopulmonary exercise testing revealed higher cardiac event rates in atrial fibrillation versus sinus rhythm patients (34.7% vs 20.1%), with VE-VCO2 slope being the sole predictor in AF.
Why the study?
Do cardiopulmonary exercise testing parameters predict cardiac death and cardiac events in cardiac patients with atrial fibrillation compared to those with sinus rhythm?
Cohort (n=550)
Do cardiopulmonary exercise testing parameters predict cardiac death and cardiac events in cardiac patients with atrial fibrillation compared to those with sinus rhythm?
Absolute Event Rate: 34.7% vs 20.1%
VE-VCO2 slope is a stronger prognostic marker than peak VO2 for predicting cardiac events in patients with atrial fibrillation undergoing cardiopulmonary exercise testing.
Parameters obtained from cardiopulmonary exercise testing (CPX) are recognized for their high prognostic value in predicting future cardiac events in cardiac patients. Our group compared the prognostic value of CPX parameters between patients with sinus rhythm (SR) and patients with atrial fibrillation (AF).Peak O2 uptake (VO2), the ratio of the increase in VO2 to the increase in work rate (ΔVO2/ΔWR), and the slope of the increase in ventilation to the increase in CO2 output (VE-VCO2 slope) were obtained from CPX in 72 AF patients and 478 SR patients. The prognostic values of these indices were compared between the two groups.Six cardiac deaths and 25 cardiac events were observed in the AF group and 9 cardiac deaths and 96 cardiac events were observed in the SR group, over a prospective follow-up period of 1,192 days. The percentages of cardiac deaths and cardiac events were higher in the AF group than in the SR group. In a multivariate Cox proportional hazards analysis, peak VO2 was identified as a sole significant predictor of cardiac death and cardiac events in SR patients and VE-VCO2 slope was identified as a sole significant predictor of cardiac death and cardiac events in AF patients.Our results suggest that the VE-VCO2 slope is strongly predictive of future cardiac events in patients with AF and that peak VO2 is strongly predictive of future cardiac events in SR patients.
No takes yet. Share an insight, caveat, or question.
Tsuneoka et al. (2012) conducted a cohort in Cardiac patients with atrial fibrillation or sinus rhythm (n=550). Cardiopulmonary exercise testing (CPX) vs. Sinus rhythm was evaluated on Cardiac death and cardiac events. Cardiopulmonary exercise testing revealed higher cardiac event rates in atrial fibrillation versus sinus rhythm patients (34.7% vs 20.1%), with VE-VCO2 slope being the sole predictor in AF.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: