Exercise oscillatory ventilation and prognosis in heart failure patients with reduced and mid-range ejection fraction.
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Rovai Sara, Corrà Ugo, Piepoli Massimo, Vignati Carlo, Salvioni Elisabetta, Bonomi Alice, Mattavelli Irene, Arcari Luca, Scardovi Angela B, Perrone Filardi Pasquale, Lagioia Rocco, Paolillo Stefania, Magrì Damiano, Limongelli Giuseppe, Metra Marco, Senni Michele, Scrutinio Domenico, Raimondo Rosa, Emdin Michele, Lombardi Carlo, Cattadori Gaia, Parati Gianfranco, Re Federica, Cicoira Mariantonietta, Villani Giovanni Q, Minà Chiara, Correale Michele, Frigerio Maria, Perna Enrico, Mapelli Massimo, Magini Alessandra, Clemenza Francesco, Bussotti Maurizio, Battaia Elisa, Guazzi Marco, Bandera Francesco, Badagliacca Roberto, Di Lenarda Andrea, Pacileo Giuseppe, Maggioni Aldo, Passino Claudio, Sciomer Susanna, Sinagra Gianfranco, Agostoni Piergiuseppe, MECKI Score Research Group (see Appendix 1)
Аннотация
METHODS AND RESULTS: We analysed 1239 patients with HFmrEF and 4482 patients with HFrEF, enrolled in the MECKI score database, with a 2-year follow-up. The study endpoint was the composite of cardiovascular death, urgent heart transplant, and ventricular assist device implantation. We identified EOV in 968 cases (16% and 17% of cases in HFmrEF and HFrEF, respectively). HFrEF EOV+ patients were significantly older, and their parameters suggested a more severe HF than HFrEF EOV- patients. A similar behaviour was found in HFmrEF EOV+ vs. EOV- patients. Kaplan-Meier analysis, irrespective of ejection fraction, showed that EOV is associated with a worse survival, and that patients with HFrEF and HFmrEF EOV+ had a significantly worse outcome than the EOV- of the same ejection fraction groups. EOV-associated survival differences in HFmrEF patients started after 18 months of follow-up.
CONCLUSION: Exercise oscillatory ventilation has a similar prevalence and ominous prognostic value in both HFmrEF and HFrEF patients, indicating a group of patients in need of a more intensive follow-up and a more aggressive therapy. In HFmrEF, the survival curves between EOV+ and EOV- patients diverged only after 18 months.