Age-Stratified Prognostic Value of Cardiopulmonary Exercise Testing Parameters in Patients With Heart Failure

Area of Science:

• Cardiology
• Exercise Physiology
• Geriatrics

Background:

• The prognostic significance of cardiopulmonary exercise testing (CPET) parameters, specifically peak oxygen consumption (VO2) and the VE/VCO2 slope, in elderly heart failure (HF) patients (≥80 years) is not well-established.
• Existing research often lacks age-specific analyses, leaving a gap in understanding CPET's utility across different age demographics.

Purpose of the Study:

• To investigate the prognostic value of CPET parameters in predicting adverse outcomes in heart failure patients.
• To perform an age-stratified analysis of CPET parameters to determine their predictive accuracy in different age groups, including the elderly.

Main Methods:

• A retrospective multicenter cohort study involving 830 heart failure patients who underwent CPET.
• Patients were categorized into three age groups: 20-64 years, 65-79 years, and ≥80 years.
• The primary endpoint was a composite of all-cause mortality or HF hospitalization within three years.

Main Results:

• Over a median follow-up of 2.8 years, 176 patients experienced adverse outcomes.
• Peak VO2 demonstrated prognostic value in patients aged 65 and older, with a stronger association in the ≥80 years group (HR: 0.72).
• The VE/VCO2 slope showed consistent prognostic association across all age groups, while the predictive accuracy of peak VO2 increased with age.

Conclusions:

• CPET parameters are associated with adverse outcomes in heart failure patients across all age groups.
• The prognostic utility of peak VO2 is most significant in older heart failure patients (≥80 years).
• CPET plays a crucial role in risk stratification for older heart failure patients, guiding clinical management and improving patient outcomes.