Heart failure prognosis over time: how the prognostic role of oxygen consumption and ventilatory efficiency during exercise has changed in the last 20 years.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Paolillo Stefania, Veglia Fabrizio, Salvioni Elisabetta, Corrà Ugo, Piepoli Massimo, Lagioia Rocco, Limongelli Giuseppe, Sinagra Gianfranco, Cattadori Gaia, Scardovi Angela B, Metra Marco, Senni Michele, Bonomi Alice, Scrutinio Domenico, Raimondo Rosa, Emdin Michele, Magrì Damiano, Parati Gianfranco, Re Federica, Cicoira Mariantonietta, Minà Chiara, Correale Michele, Frigerio Maria, Bussotti Maurizio, Battaia Elisa, Guazzi Marco, Badagliacca Roberto, Di Lenarda Andrea, Maggioni Aldo, Passino Claudio, Sciomer Susanna, Pacileo Giuseppe, Mapelli Massimo, Vignati Carlo, Clemenza Francesco, Binno Simone, Lombardi Carlo, Filardi Pasquale Perrone, Agostoni Piergiuseppe, MECKI Score Research Group (see Appendix)
Аннотация
METHODS AND RESULTS: Data from 6083 HF patients (81% male, age 61 ± 13 years), enrolled in the MECKI score database between 1993 and 2015, were retrospectively analysed. By enrolment year, four groups were generated: group 1 1993-2000 (n = 440), group 2 2001-2005 (n = 1288), group 3 2006-2010 (n = 2368), and group 4 2011-2015 (n = 1987). We compared the 10-year survival of groups and analysed how the overall risk (cardiovascular death, urgent heart transplantation, or left ventricular assist device implantation) changed over time according to peak VO2 and VE/VCO2 slope and to major clinical and therapeutic variables. At 10 years, a progressively higher survival from group 1 to group 3 was observed, with no further improvement afterwards. A 20% risk for peak VO2 15 mL/min/kg (95% confidence interval 16-13), 9 (11-8), 4 (4-2) and 5 (7-4) was observed in group 1, 2, 3, and 4, respectively, while the VE/VCO2 slope value for a 20% risk was 32 (37-29), 47 (51-43), 59 (64-55), and 57 (63-52), respectively.
CONCLUSIONS: Heart failure prognosis improved over time up to 2010 in a HF population followed by experienced centres. The peak VO2 and VE/VCO2 slope cut-offs identifying a definite risk progressively decreased and increased over time, respectively. The prognostic threshold of peak VO2 and VE/VCO2 slope must be updated whenever HF prognosis improves.