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Age Differences in Cardiopulmonary Exercise Testing Parameters in Heart Failure with Reduced Ejection Fraction
Pedro Garcia Brás1, António Valentim Gonçalves1, João Ferreira Reis1
1Cardiology Department, Santa Marta Hospital, Central Lisbon Hospital University Center, 1169-024 Lisbon, Portugal.
Medicina (Kaunas, Lithuania)
|September 28, 2023
Summary
Cardiopulmonary exercise testing (CPET) effectively predicts outcomes in heart failure with reduced ejection fraction (HFrEF). Age-specific thresholds for CPET parameters improve risk stratification accuracy in HFrEF patients.
Area of Science:
- Cardiology
- Exercise Physiology
Background:
- Cardiopulmonary exercise testing (CPET) is crucial for risk stratification in heart failure with reduced ejection fraction (HFrEF).
- Limited evidence exists regarding CPET's predictive value in older HFrEF populations.
Purpose of the Study:
- To assess the prognostic capability of current heart transplantation (HTx) listing criteria in HFrEF patients across different age groups.
- To determine if age-specific thresholds enhance risk stratification accuracy.
Main Methods:
- A cohort of 458 HFrEF patients underwent CPET between 2009 and 2018.
- Patients were followed for cardiac death and urgent HTx.
- Analysis included peak oxygen uptake (pVO2), VE/VCO2 slope, and % predicted pVO2.
Main Results:
- The composite endpoint occurred in 16.8% of patients ≤50 years and 14.1% of patients ≥50 years over 36 months.
- pVO2, VE/VCO2 slope, and % predicted pVO2 were independent predictors of outcomes.
- International Society for Heart and Lung Transplantation thresholds showed higher diagnostic effectiveness in younger patients (≤50 years).
Conclusions:
- Personalized, age-specific CPET thresholds can improve risk stratification accuracy in HFrEF.
- Further research is needed to clarify CPET's prognostic role in older HFrEF patients.
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