Cardiopulmonary Exercise Testing in Patients with Heart Failure: Impact of Gender in Predictive Value for Heart Transplantation Listing

Pedro Garcia Brás, António Valentim Gonçalves, João Ferreira Reis, Rita Ilhão Moreira, Tiago Pereira-da-Silva, Pedro Rio, Ana Teresa Timóteo, Sofia Silva, Rui M Soares, Rui Cruz Ferreira

Research output: Contribution to journalArticlepeer-review

12 Downloads (Pure)

Abstract

BACKGROUND: Exercise testing is key in the risk stratification of patients with heart failure (HF). There are scarce data on its prognostic power in women. Our aim was to assess the predictive value of the heart transplantation (HTx) thresholds in HF in women and in men.

METHODS: Prospective evaluation of HF patients who underwent cardiopulmonary exercise testing (CPET) from 2009 to 2018 for the composite endpoint of cardiovascular mortality and urgent HTx.

RESULTS: A total of 458 patients underwent CPET, with a composite endpoint frequency of 10.5% in females vs. 16.0% in males in 36-month follow-up. Peak VO2 (pVO2), VE/VCO2 slope and percent of predicted pVO2 were independent discriminators of the composite endpoint, particularly in women. The International Society for Heart Lung Transplantation recommended values of pVO2 ≤ 12 mL/kg/min or ≤14 if the patient is intolerant to β-blockers, VE/VCO2 slope > 35, and percent of predicted pVO2 ≤ 50% showed a higher diagnostic effectiveness in women. Specific pVO2, VE/VCO2 slope and percent of predicted pVO2 cut-offs in each sex group presented a higher prognostic power than the recommended thresholds.

CONCLUSION: Individualized sex-specific thresholds may improve patient selection for HTx. More evidence is needed to address sex differences in HF risk stratification.

Original languageEnglish
Article number1985
JournalLife (Basel, Switzerland)
Volume13
Issue number10
DOIs
Publication statusPublished - Oct 2023

Keywords

  • gender
  • heart failure
  • heart transplantation
  • cardiopulmonary exercise testing
  • peak O2 consumption

Fingerprint

Dive into the research topics of 'Cardiopulmonary Exercise Testing in Patients with Heart Failure: Impact of Gender in Predictive Value for Heart Transplantation Listing'. Together they form a unique fingerprint.

Cite this