科研之友
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摘要
Background: Exercise oscillatory ventilation (EOV) has been shown to be a powerful prognostic marker in chronic heart failure (CHF). However, EOV is poorly defined, its measurement lacks standardization and it is underutilized in clinical practice. The purpose of this pilot studywas to investigate the prognostic value of amodified definition of EOV in patients with CHF. Methods: Eighty-nine CHF patients (56.5 +/- 8.4 years) (64% NYHA class III-IV) underwent cardiopulmonary exercise testing. EOV was defined as meeting all the following criteria: (1) = 3 consecutive cyclic fluctuations of ventilation during exercise; (2) average amplitude over 3 ventilatory oscillations = 5 L; and (3) an average length of three oscillatory cycles 40s to 140 s. Adverse cardiac events were tracked during 28 +/- 19 months follow up. Cox proportional hazard analysis was used to determine the association between cardiac events and EOV. Results: Forty-eight patients (54%) met all three criteria andwere determined to have EOV. These patients exhibited significantly increased risk for adverse cardiac events [hazard ratio=2.2, 95% CI (1.2 to 4.1), p=0.011] compared to patients without EOV. After adjusting for age and established prognostic covariates (peak VO2 and V-E/VCO2 slope), the modified EOV definition was the only significant variable in the multivariate model [hazard ratio = 2.0, 95% CI (1.1 to 3.7), p = 0.035]. Conclusions: The proposedmethod for determining EOVwas independently associated with increased risk for adverse cardiac events in CHF patients. While larger prospective studies are needed, this definition provides a relatively simple and more objective characterization of EOV, suggesting its potential application in clinical practice.
- 出版日期2017-12-15
