European journal of preventive cardiology · 2026
A novel method to classify exercise response in patients with cardiac amyloidosis - The RoMa classification.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kösters Antonio, Ermolaev Nikita, Salvioni Elisabetta, Eslami Mahshid, Seilinger Lisa, Contini Mauro, Vignati Carlo, Campodonico Jeness, Mattavelli Irene, Puttini Fiorella, Agostoni Piergiuseppe, Badr Eslam Roza, Willixhofer Robin, Mapelli Massimo
Аннотация
AIMS: To evaluate the applicability of the RoMa classification in patients with transthyretin cardiac amyloidosis (ATTR-CM) and to assess its association with functional capacity and key cardiopulmonary exercise testing (CPET) parameters.
METHODS: Consecutive adults (≥18 years) with confirmed ATTR-CM from two tertiary centres who completed symptom-limited maximal CPET were included. RoMa classes were defined using predefined cutoffs for percent-predicted peak heart rate (HRpp ≥80%) and percent-predicted peak O2-pulse (O2pp ≥100%): RoMa I (high HRpp/high O2pp), RoMa II (high HRpp/low O2pp), RoMa III (low HRpp/high O2pp), and RoMa IV (low HRpp/low O2pp).
RESULTS: We evaluated 165 patients (90% male; 77% wild-type ATTR, 20% variant ATTR). RoMa distribution was: RoMa I, n=33; RoMa II, n=73; RoMa III, n=30; and RoMa IV, n=29. Age did not differ across classes (p=0.36). Functional capacity declined across the RoMa strata: median 6MWD decreased from 420 m (RoMa I) to 313 m (RoMa IV) (overall p=0.009; p-trend=0.005), and NYHA class worsened (overall p=0.003; p-trend=0.005). Peak VO2 (% predicted) differed between groups (RoMa I: 93.0; II: 70.8; III: 75.2; IV: 51.9; overall p<0.001; p-trend<0.001), and ventilatory inefficiency increased (VE/VCO2 slope: 34; 39; 37; 47, respectively; overall p<0.001; p-trend<0.001; peak PetCO2: 30; 27; 29; 25, respectively; overall p<0.001; p-trend=0.003). 6MWD correlated with peak VO2 (r=0.626; p<0.001; n=131) and inversely with VE/VCO2 slope (ρ=-0.484; p<0.001; n=130).
CONCLUSION: In ATTR-CM, application of the RoMa classification was feasible and identified distinct CPET-derived exercise-response profiles associated with functional impairment. These findings support RoMa as a promising exploratory framework for functional phenotyping in ATTR-CM.
METHODS: Consecutive adults (≥18 years) with confirmed ATTR-CM from two tertiary centres who completed symptom-limited maximal CPET were included. RoMa classes were defined using predefined cutoffs for percent-predicted peak heart rate (HRpp ≥80%) and percent-predicted peak O2-pulse (O2pp ≥100%): RoMa I (high HRpp/high O2pp), RoMa II (high HRpp/low O2pp), RoMa III (low HRpp/high O2pp), and RoMa IV (low HRpp/low O2pp).
RESULTS: We evaluated 165 patients (90% male; 77% wild-type ATTR, 20% variant ATTR). RoMa distribution was: RoMa I, n=33; RoMa II, n=73; RoMa III, n=30; and RoMa IV, n=29. Age did not differ across classes (p=0.36). Functional capacity declined across the RoMa strata: median 6MWD decreased from 420 m (RoMa I) to 313 m (RoMa IV) (overall p=0.009; p-trend=0.005), and NYHA class worsened (overall p=0.003; p-trend=0.005). Peak VO2 (% predicted) differed between groups (RoMa I: 93.0; II: 70.8; III: 75.2; IV: 51.9; overall p<0.001; p-trend<0.001), and ventilatory inefficiency increased (VE/VCO2 slope: 34; 39; 37; 47, respectively; overall p<0.001; p-trend<0.001; peak PetCO2: 30; 27; 29; 25, respectively; overall p<0.001; p-trend=0.003). 6MWD correlated with peak VO2 (r=0.626; p<0.001; n=131) and inversely with VE/VCO2 slope (ρ=-0.484; p<0.001; n=130).
CONCLUSION: In ATTR-CM, application of the RoMa classification was feasible and identified distinct CPET-derived exercise-response profiles associated with functional impairment. These findings support RoMa as a promising exploratory framework for functional phenotyping in ATTR-CM.