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Cardiopulmonary exercise testing may not predict appropriate implantable cardioverter defibrillator therapies in

Gabriela Bem1,2, Mauricio Pimentel1,2, Alice K Bublitz2

  • 1Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

Acta Cardiologica
|June 7, 2019
PubMed

Insights

Cardiopulmonary exercise testing (CPET) variables like peak oxygen uptake and VE/VCO2 slope do not predict appropriate implantable cardioverter-defibrillator (ICD) therapies in heart failure patients. Further research is needed to clarify the role of CPET in this population.

Area of Science:

  • Cardiology
  • Exercise Physiology

Background:

  • Cardiopulmonary exercise testing (CPET) variables are established predictors of major cardiovascular events in heart failure (HF).
  • The predictive value of CPET variables for appropriate implantable cardioverter-defibrillator (ICD) therapies in HF patients remains under-investigated.

Purpose of the Study:

  • To evaluate CPET variables, including peak oxygen uptake (VO2 peak), VE/VCO2 slope, and exercise-related periodic breathing (EPB), as predictors of appropriate ICD therapy in HF patients.
  • To assess the prognostic significance of these CPET parameters for ICD interventions in primary prevention.

Main Methods:

  • Retrospective analysis of 61 HF patients who underwent CPET and received ICD for primary prevention.
  • Follow-up period of 767 ± 601 days, with the primary outcome being appropriate ICD therapy (anti-tachycardia pacing or shock).

Main Results:

  • The study cohort comprised predominantly male patients (65.6%) with severe left ventricular ejection fraction (LVEF) of 27 ± 6%.
  • Appropriate ICD therapy occurred in 32% of patients (20 out of 61).
  • No significant differences in VO2 peak, VE/VCO2 slope, or EPB prevalence were observed between patients with and without appropriate ICD therapy. Cox regression analysis indicated none of these CPET variables were significant predictors.

Conclusions:

  • CPET variables, including VO2 peak, VE/VCO2 slope, and EPB, did not demonstrate predictive value for appropriate ICD therapies in this cohort of HF patients.
  • Larger-scale studies are necessary to definitively ascertain the role of CPET in predicting ICD therapies for heart failure management.

Keywords:
Exercise testcardiac sudden deathheart failureimplantable cardioverter-defibrillatorventricular tachycardia

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