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The double anaerobic threshold in heart failure: MECKI score database overview
Sara Rovai1, Denise Zaffalon2, Marco Cittar2
1Department of Heart Failure and Clinical Cardiology, Centro Cardiologico Monzino, IRCCS, Via Parea 4, Milan, 20138, Italy.
ESC Heart Failure
|May 17, 2022
Summary
Double threshold (DT) is common in heart failure (HF) patients, appearing in 43% of cases. This finding, however, did not correlate with patient survival rates in the study.
Area of Science:
- Cardiology
- Exercise Physiology
- Pulmonary Medicine
Background:
- Anaerobic threshold (AT) is a crucial prognostic indicator in heart failure (HF), though it can be challenging to determine.
- The V-slope, ventilatory equivalent, and end-tidal methods are used to assess AT.
- A discrepancy between V-slope (met AT) and the other two methods (vent AT) is termed double threshold (DT) and has been observed in healthy individuals.
Purpose of the Study:
- To investigate the prevalence and clinical significance of double threshold (DT) in heart failure (HF) patients.
- To analyze the association between DT and exercise response characteristics in HF.
- To determine the prognostic value of DT for survival in HF patients.
Main Methods:
- Re-analysis of 1075 cardiopulmonary exercise tests from the MECKI score database for HF patients.
- Identification of DT by comparing V-slope AT with ventilatory AT (vent AT).
- Kaplan-Meier survival analysis was performed, adjusting for potential confounders.
Main Results:
- Double threshold (DT) was identified in 43% of the analyzed HF patients.
- Patients with DT showed a decreased ventilatory response during exercise, evidenced by a lower VE/VCO2 slope and PetO2, and higher PetCO2.
- Despite differences in exercise parameters, DT was not associated with 2-year survival in HF patients.
Conclusions:
- Double threshold (DT) is a frequent finding in heart failure (HF) patients.
- The presence of DT is linked to a diminished ventilatory response during exercise.
- DT does not appear to be an independent predictor of survival in HF patients.
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