Key result
Higher exercise E/e' is linked to ~58% increased cardiac events in preclinical heart failure.
Why the study?
Comprehensive screening for new-onset heart failure in patients with stage A or B HF is cost-prohibitive, necessitating further risk stratification methods.
Does cardiopulmonary exercise test with bicycle stress echocardiography predict adverse cardiac events in patients with stage A or B heart failure?
Cohort (n=410)
No
Does cardiopulmonary exercise test with bicycle stress echocardiography predict adverse cardiac events in patients with stage A or B heart failure?
Hazard Ratio: 1.582 (95% CI 1.199–2.087)
p-value: p=0.001
CPET-BSE parameters, specifically VE/VCO2 slope, VO2 at peak exercise, time to ventilatory threshold, and exercise E/e', are independent predictors of future heart failure hospitalization or cardiac death in patients with stage A or B heart failure.
Exercise E/e' may refine risk stratification in stage A/B HF; leaves open its incremental value and need for prospective validation.
Background: Given the high prevalence of stage A or B heart failure (HF), comprehensive screening for new-onset HF is cost-prohibitive. Therefore, further risk stratification is warranted to identify at-risk patients. This study aimed to evaluate the prognostic utility of cardiopulmonary exercise test (CPET) with bicycle stress echocardiography (BSE) in patients with stage A or B HF. Methods: Among 687 consecutive patients who underwent CPET-BSE, 410 with stage A or B HF were analyzed. The association between the CPET-BSE parameters and adverse cardiac events (hospitalization for HF or cardiac-related death) was analyzed using the Cox proportional hazard model under univariate and multivariate analyses. Results: at peak exercise (HR 1.164, 95 % CI 1.022-1.325), time to VT (HR 0.993, 95 % CI 0.989-0.997), and exercise E/e' (HR 1.582, 95 % CI 1.199-2.087) were only independent predictors for events. Conclusions: In patients with stage A or B HF, four parameters of CPET-BSE were good predictors of future development of HF or cardiac death. If patients are unable to perform complete exercise, the time to VT may serve as a sufficiently predictive parameter for clinical events.
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Ahn et al. (2024) conducted a cohort in Stage A or B heart failure (n=410). Exercise E/e' (CPET-BSE parameter) vs. Lower exercise E/e' values was evaluated on Adverse cardiac events (hospitalization for HF or cardiac-related death) (HR 1.582, 95% CI 1.199-2.087, p=0.001). Exercise E/e' independently predicted adverse cardiac events (HR 1.582) in patients with stage A or B heart failure.
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