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Prognostic Prediction of Cardiopulmonary Exercise Test Parameters in Heart Failure Patients with Atrial Fibrillation

2020Journal article Open access
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dc.contributor.authorValentim Gonçalves, A
dc.contributor.authorPereira-da-Silva, T
dc.contributor.authorSoares, R
dc.contributor.authorFeliciano, J
dc.contributor.authorIlhão Moreira, R
dc.contributor.authorRio, P
dc.contributor.authorAbreu, A
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2020-05-20T15:53:59Z
dc.date.available2020-05-20T15:53:59Z
dc.date.issued2020
dc.description.abstractBackground: Atrial fibrillation (AF) is associated with increased mortality in heart failure (HF) patients. Objective: To evaluate whether the risk of AF patients can be precisely stratified by relation with cardiopulmonary exercise test (CPET) cut-offs for heart transplantation (HT) selection. Methods: Prospective evaluation of 274 consecutive HF patients with left ventricular ejection fraction ≤ 40%. The primary endpoint was a composite of cardiac death or urgent HT in 1-year follow-up. The primary endpoint was analysed by several CPET parameters for the highest area under the curve and for positive (PPV) and negative predictive value (NPV) in AF and sinus rhythm (SR) patients to detect if the current cut-offs for HT selection can precisely stratify the AF group. Statistical differences with a p-value <0.05 were considered significant. Results: There were 51 patients in the AF group and 223 in the SR group. The primary outcome was higher in the AF group (17.6% vs 8.1%, p = 0.038). The cut-off value of pVO2 for HT selection showed a PPV of 100% and an NPV of 95.5% for the primary outcome in the AF group, with a PPV of 38.5% and an NPV of 94.3% in the SR group. The cut-off value of VE/VCO2 slope showed lower values of PPV (33.3%) and similar NPV (92.3%) to pVO2 results in the AF group. Conclusion: Despite the fact that AF carries a worse prognosis for HF patients, the current cut-off of pVO2 for HT selection can precisely stratify this high-risk group.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationArq Bras Cardiol. 2020 Feb;114(2):209-218.pt_PT
dc.identifier.doi10.36660/abc.20180193pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3449
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSociedade Brasileira de Cardiologiapt_PT
dc.subjectHSM CARpt_PT
dc.subjectAtrial Fibrillation/mortalitypt_PT
dc.subjectFollow-Up Studiespt_PT
dc.subjectExercise Test/methodspt_PT
dc.subjectHeart Failure/physiopathologypt_PT
dc.subjectHeart Failure/mortalitypt_PT
dc.subjectOxygen/metabolismpt_PT
dc.subjectAtrial Fibrillation/physiopathology
dc.subjectExercise Test/standards
dc.subjectMultivariate Analysis
dc.subjectOxygen Consumption/physiology
dc.subjectPrognosis
dc.subjectProportional Hazards Models
dc.subjectProspective Studies
dc.subjectReference Standards
dc.subjectRisk Assessment/standards
dc.subjectRisk Factors
dc.subjectStatistics, Nonparametric
dc.subjectStroke Volume/physiology
dc.subjectTime Factors
dc.titlePrognostic Prediction of Cardiopulmonary Exercise Test Parameters in Heart Failure Patients with Atrial Fibrillationpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage218pt_PT
oaire.citation.issue2pt_PT
oaire.citation.startPage209pt_PT
oaire.citation.titleArquivos Brasileiros de Cardiologiapt_PT
oaire.citation.volume114pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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