Prognostic Significance of Peak Workload-to-Weight Ratio by Cardiopulmonary Exercise Testing in Chronic Heart Failure

Yasui, Yutaro; Nakamura, Kosuke; Omote, Kazunori; Ishizaka, Shoji; Takenaka, Sakae; Mizuguchi, Yoshifumi; Shimono, Yui; Kazui, Sho; Takahashi, Yuki; Saiin, Kohei; Naito, Seiichiro; Tada, Atsushi; Kobayashi, Yuta; Sato, Takuma; Kamiya, Kiwamu; Nagai, Toshiyuki; Anzai, Toshihisa

doi:10.1016/j.amjcard.2023.01.052

Cited by 2 publications

(1 citation statement)

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“…When describing the relation between exercise capacity and LV size, neither W peak nor LVEDD were indexed to body size or age. When determining whether exercise capacity is reduced or not, W peak should be related to anthropometric data (including sex and age) 13 , 18 . Reference values for exercise capacity using standardized cycle ergometer exercise test in Sweden has been published, in which age, sex and height, but not weight, are included in the regression equation 25 .…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of peak work rate indexed by left ventricular diameter

Gustafsson

Ekström

Brudin

et al. 2023

Sci Rep

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Left ventricular diameter (LVEDD) increases with systematic endurance training but also in various cardiac diseases. High exercise capacity associates with favorable outcomes. We hypothesized that peak work rate (Wpeak) indexed to LVEDD would carry prognostic information and aimed to evaluate the association between Wpeak/LVEDDrest and cardiovascular mortality. Wpeak/LVEDDrest (W/mm) was calculated in patients with an echocardiographic examination within 3 months of a maximal cycle ergometer exercise test. Low Wpeak/LVEDDrest was defined as a value below the sex- and age-specific 5th percentile among lower-risk subjects. The association with cardiovascular mortality was evaluated using Cox regression. In total, 3083 patients were included (8.0 [5.4–11.1] years of follow-up, 249 (8%) cardiovascular deaths). Wpeak/LVEDDrest (W/mm) was associated with cardiovascular mortality (adjusted hazard ratio (HR) 0.28 [0.22–0.36]), similar to Wpeak in % of predicted, with identical prognostic strength when adjusted for age and sex (C-statistics 0.87 for both). A combination of low Wpeak/LVEDDrest and low Wpeak was associated with a particularly poor prognosis (adjusted HR 6.4 [4.0–10.3]). Wpeak/LVEDDrest was associated with cardiovascular mortality but did not provide incremental prognostic value to Wpeak alone. The combination of a low Wpeak/LVEDDrest and low Wpeak was associated with a particularly poor prognosis.

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Section: Discussionmentioning

confidence: 99%