Ventilatory Expired Gas at Constant-Rate Low-Intensity Exercise Predicts Adverse Events and is Related to Neurohormonal Markers in Patients With Heart Failure

Ross Arena, Dean MacCarter, Thomas P. Olson, Sophie Lalande, Maile L. Ceridon, Lyle J. Olson, Bruce Johnson

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Background: Ventilatory efficiency (VE/VCO2 ratio) and the partial pressure of end-tidal carbon dioxide (PETCO2), obtained during moderate to high levels of physical exertion demonstrate prognostic value in heart failure (HF). The present investigation assesses the clinical utility of these variables during low-intensity exercise. Methods and Results: One hundred and thirty subjects diagnosed with HF underwent a 2-minute, constant-rate treadmill session at 2 miles per hour. Both the VE/VCO2 ratio and PETCO2 were recorded during exercise (30-second average) and their change (Δ) from rest. B-type and atrial natriuretic peptide (BNP and ANP) were also determined. Only PETCO2 and ΔPETCO2 emerged from the multivariate Cox regression. Receiver operating characteristic curve analysis revealed the prognostic classification schemes were significant with thresholds of </≥34 mm Hg (hazard ratio: 4.2, 95% CI: 2.2-8.0, P < .001) and </≥1 mm Hg (hazard ratio: 3.5, 95% CI: 1.9-6.6, P < .001) being optimal for PETCO2 and ΔPETCO2, respectively. Moreover, subjects with a PETCO2≥34 mm Hg had a significantly lower BNP (214.1 ± 431.9 vs. 1110.5 ± 1854.0 pg/mL, P=.005) and ANP (108.2 ± 103.6 vs. 246.2 ± 200.4 pg/mL, P < .001). Conclusions: The results of this pilot study indicate ventilatory expired gas analysis during a short bout of low-intensity exercise may provide insight into prognosis and cardiac stability.

Original languageEnglish (US)
Pages (from-to)482-488
Number of pages7
JournalJournal of Cardiac Failure
Volume15
Issue number6
DOIs
StatePublished - Aug 1 2009

Keywords

  • Cardiopulmonary
  • carbon dioxide
  • prognosis
  • ventilatory efficiency

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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