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The Prognostic Value of the Cardiorespiratory Optimal Point During Submaximal Exercise Testing in Heart Failure

dc.contributor.authorFerreira Reis, J
dc.contributor.authorValentim Gonçalves, A
dc.contributor.authorBrás, P
dc.contributor.authorMoreira, R
dc.contributor.authorPereira-da-Silva, T
dc.contributor.authorTimóteo, AT
dc.contributor.authorSoares, RM
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2022-12-22T14:52:28Z
dc.date.available2022-12-22T14:52:28Z
dc.date.issued2022
dc.description.abstractIntroduction: Peak oxygen consumption (pVO2) is a key parameter for assessing the prognosis of heart failure with reduced ejection fraction (HFrEF). However, it is less reliable when the cardiopulmonary exercise test (CPET) is not maximal. Objective: To compare the prognostic power of various exercise parameters in submaximal CPET. Methods: Adult patients with HFrEF undergoing CPET in a tertiary center were prospectively assessed. Submaximal CPET was defined as a respiratory exchange ratio ≤1.10. Patients were followed for one year for the primary endpoint of cardiac death and urgent heart transplantation (HT). Various CPET parameters were analyzed as potential predictors of the combined endpoint and their prognostic power (area under the curve [AUC]) was compared using the Hanley-McNeil test. Results: CPET was performed in 442 HFrEF patients (mean age 56±12 years, 80% male), of whom 290 (66%) had a submaximal CPET. Seventeen patients (6%) reached the primary endpoint. The cardiorespiratory optimal point (COP) had the highest AUC value (0.989, p<0.001), and significantly higher prognostic power than other tested parameters, with pVO2 presenting an AUC of 0.753 (p=0.001). COP ≥36 had significantly lower survival free of HT during follow-up (p<0.001) and presented a sensitivity of 100% and a specificity of 89% for the primary endpoint. Conclusion: COP had the highest prognostic power of all parameters analyzed in a submaximal CPET. This parameter can help stratify HFrEF patients who are physiologically unable to reach a maximal level of exercise.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol . 2022 Sep;41(9):751-758.pt_PT
dc.identifier.doi10.1016/j.repc.2021.06.023.pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4326
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevier Españapt_PT
dc.subjectHSM CARpt_PT
dc.subjectCardiorespiratory Optimal Pointpt_PT
dc.subjectExercise Testpt_PT
dc.subjectHeart Failurept_PT
dc.subjectRisk Stratificationpt_PT
dc.subjectSubmaximalpt_PT
dc.titleThe Prognostic Value of the Cardiorespiratory Optimal Point During Submaximal Exercise Testing in Heart Failurept_PT
dc.title.alternativeO Valor Prognóstico do Ponto Ótimo Cardiorrespiratório após Prova de Esforço Cardiorrespiratória Submáxima na Insuficiência Cardíacapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage758pt_PT
oaire.citation.startPage751pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologiapt_PT
oaire.citation.volume41pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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