Key result
A high VE/VCO2 slope (>34) was associated with a significantly higher 3-year cardiac event rate compared to a low slope (32.1% vs 18.9%, p<0.05) in patients with heart disease.
Why the study?
Does a high VE/VCO2 slope (>34) predict cardiac events in patients with various heart diseases and preserved exercise tolerance?
Cohort (n=215)
No
Does a high VE/VCO2 slope (>34) predict cardiac events in patients with various heart diseases and preserved exercise tolerance?
Absolute Event Rate: 32.1% vs 18.9%
p-value: p=<0.05
The VE/VCO2 slope is a significant prognostic indicator for cardiac events in a heterogeneous group of heart disease patients, independent of exercise tolerance.
VE/VCO2 slope >34 identifies higher event risk across heart diseases even with preserved peak VO2; leaves open incremental clinical utility.
BACKGROUND: The minute ventilation/carbon-dioxide output (VE/VCO2) slope as a marker of cardiac events has been established in patients with severe heart failure, but it is not known whether it is useful for other heart diseases. METHODS AND RESULTS: The present study investigated 215 patients with various heart diseases (age 59+/-11 years; ischemic heart disease, n=89; dilated cardiomyopathy, n=38; valvular disease, n=37; hypertensive heart disease, n=33; others, n=18) who underwent cardiopulmonary exercise testing to determine the VE/VCO(2) slope. Patients were divided into 2 groups according to the VE/VCO2 slope and were followed-up for 3 years. Forty-eight cardiac events (6 deaths, 42 re-hospitalizations) occurred during the observation period. Patients with a VE/VCO2 slope >34 had a significantly higher 3-year cardiac event rate (32.1%) than patients with VE/VCO2 slope <34 (18.9%, p<0.05). When patients were selected with relatively preserved peak oxygen uptake values (>16 ml . kg (-1) . min(-1)), patients with VE/VCO2 slope >34 still demonstrated a significantly higher cardiac event rate than other patients (35.0% vs 13.3%, p<0.01). CONCLUSION: The VE/VCO2 slope may be a prognostic indicator of cardiac events in a heterogeneous group of patients with heart disease, independent of exercise tolerance.
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Tsurugaya et al. (2006) conducted a cohort in Heart disease (NYHA class I or II) (n=215). High VE/VCO2 slope (>34) vs. Low VE/VCO2 slope (<34) was evaluated on 3-year cardiac events (death from heart failure or re-hospitalization) (p=<0.05). A high VE/VCO2 slope (>34) was associated with a significantly higher 3-year cardiac event rate compared to a low slope (32.1% vs 18.9%, p<0.05) in patients with heart disease.
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