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Age Differences in Cardiopulmonary Exercise Testing Parameters in Heart Failure with Reduced Ejection Fraction

2023-09Artigo científico Acesso aberto
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dc.contributor.authorGarcia Brás, Pedro
dc.contributor.authorGonçalves, António Valentim
dc.contributor.authorReis, João Ferreira
dc.contributor.authorMoreira, Rita Ilhão
dc.contributor.authorPereira-da-Silva, Tiago
dc.contributor.authorPereira-da-Silva, Tiago
dc.contributor.authorRio, Pedro
dc.contributor.authorTimóteo, Ana Teresa
dc.contributor.authorTimoteo, Ana Teresa
dc.contributor.authorSilva, Sofia
dc.contributor.authorSoares, Rui M.
dc.contributor.authorFerreira, Rui Cruz
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblMDPI - Multidisciplinary Digital Publishing Institute
dc.date.accessioned2023-10-04T22:19:02Z
dc.date.available2023-10-04T22:19:02Z
dc.date.issued2023-09
dc.description.abstractBackground and Objectives: Cardiopulmonary exercise testing (CPET) is a cornerstone of risk stratification in heart failure with reduced ejection fraction (HFrEF). However, there is a paucity of evidence on its predictive power in older patients. The aim of this study was to evaluate the prognostic power of current heart transplantation (HTx) listing criteria in HFrEF stratified according to age groups. Materials and Methods: Consecutive patients with HFrEF undergoing CPET between 2009 and 2018 were followed-up for cardiac death and urgent HTx. Results: CPET was performed in 458 patients with HFrEF. The composite endpoint occurred in 16.8% of patients ≤50 years vs. 14.1% of patients ≥50 years in a 36-month follow-up. Peak VO2 (pVO2), VE/VCO2 slope and percentage of predicted pVO2 were strong independent predictors of outcomes. The International Society for Heart and Lung Transplantation thresholds of pVO2 ≤ 12 mL/kg/min (≤14 if intolerant to β-blockers), VE/VCO2 slope > 35 and percentage of predicted pVO2 ≤ 50% presented a higher overall diagnostic effectiveness in younger patients (≤50 years). Specific thresholds for each age subgroup outperformed the traditional cut-offs. Conclusions: Personalized age-specific thresholds may contribute to an accurate risk stratification in HFrEF. Further studies are needed to address the gap in evidence between younger and older patients.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent1837635
dc.identifier.doi10.3390/medicina59091685
dc.identifier.issn1010-660X
dc.identifier.otherPURE: 73136044
dc.identifier.otherPURE UUID: 60353baa-9e2f-4688-9bee-2aa455575935
dc.identifier.otherScopus: 85172225715
dc.identifier.urihttp://hdl.handle.net/10362/158694
dc.identifier.urlhttps://www.scopus.com/pages/publications/85172225715
dc.language.isoeng
dc.peerreviewedyes
dc.subjectage
dc.subjectcardiopulmonary exercise testing
dc.subjectheart failure with reduced ejection fraction
dc.subjectheart transplantation
dc.subjectpeak oxygen consumption
dc.subjectVE/VCO slope
dc.subjectGeneral Medicine
dc.titleAge Differences in Cardiopulmonary Exercise Testing Parameters in Heart Failure with Reduced Ejection Fractionen
dc.typejournal article
degois.publication.issue9
degois.publication.titleMedicina (Lithuania)
degois.publication.volume59
dspace.entity.typePublication
person.familyNamePereira-da-Silva
person.familyNameTimoteo
person.givenNameTiago
person.givenNameAna Teresa
person.identifier.ciencia-id4E19-BD07-B1D6
person.identifier.orcid0000-0003-0467-2608
person.identifier.orcid0000-0001-6061-9663
person.identifier.scopus-author-id6701407956
rcaap.rightsopenAccess
relation.isAuthorOfPublication4c17c358-87c1-467d-82b3-91afa2999c2a
relation.isAuthorOfPublicationb3b1e09c-c5da-482e-b762-a5655bd6937d
relation.isAuthorOfPublication.latestForDiscovery4c17c358-87c1-467d-82b3-91afa2999c2a

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