A meta-analysis of the prognostic significance of cardiopulmonary exercise testing in patients with heart failure

作者：Cahalin Lawrence P^*; Chase Paul; Arena Ross; Myers Jonathan; Bensimhon Daniel; Peberdy Mary Ann; Ashley Euan; West Erin; Forman Daniel E; Pinkstaff Sherry; Lavie Carl J; Guazzi Marco

来源：Heart Failure Reviews, 2013, 18(1): 79-94.

DOI：10.1007/s10741-012-9332-0

• Ventilation
• Aerobic capacity
• Expired gas
• Exercise
• Heart disease

The objective of the study is to assess the role of cardiopulmonary exercise testing (CPX) variables, including peak oxygen consumption (VO2), which is the most recognized CPX variable, the minute ventilation/carbon dioxide production (VE/VCO2) slope, the oxygen uptake efficiency slope (OUES), and exercise oscillatory ventilation (EOV) in a current meta-analysis investigating the prognostic value of a broader list of CPX-derived variables for major adverse cardiovascular events in patients with HF. A search for relevant CPX articles was performed using standard meta-analysis methods. Of the initial 890 articles found, 30 met our inclusion criteria and were included in the final analysis. The total subject populations included were as follows: peak VO2 (7,319), VE/VCO2 slope (5,044), EOV (1,617), and OUES (584). Peak VO2, the VE/VCO2 slope and EOV were all highly significant prognostic markers (diagnostic odds ratios a parts per thousand yen 4.10). The OUES also demonstrated promise as a prognostic marker (diagnostic odds ratio = 8.08) but only in a limited number of studies (n = 2). No other independent variables (including age, ejection fraction, and beta-blockade) had a significant effect on the meta-analysis results for peak VO2 and the VE/VCO2 slope. CPX is an important component in the prognostic assessment of patients with HF. The results of this meta-analysis strongly confirm this and support a multivariate approach to the application of CPX in this patient population.

• 出版日期2013-1