Tuan Sheng-Hui, Huang I-Ching, Huang Wei-Chun, Chen Guan-Bo, Sun Shu-Fen, Lin Ko-Long
Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.
Department of Rehabilitation Medicine, Cishan Hospital, Ministry of Health and Welfare, Kaohsiung 842, Taiwan.
Life (Basel). 2024 Nov 6;14(11):1429. doi: 10.3390/life14111429.
(1) Background: Heart failure (HF) leads to functional disability and major cardiovascular events (MACEs). Cardiopulmonary exercise testing (CPET) is the gold standard for assessing aerobic capacity and prognostic stratification. This study aimed to evaluate the predischarge CPET variables in patients with acute decompensated HF and identify the submaximal CPET variables with prognostic value. (2) Methods: A retrospective cohort study was conducted at a tertiary center in Taiwan. Patients surviving their first episode of decompensated HF and undergoing predischarge CPET (February 2017 to January 2023) were analyzed. Follow-up was conducted until a MACE or administrative censoring (up to 5 years). Cox regression identified the significant predictors of MACE. (3) Results: The study included 553, 485, and 267 patients at the 3-month, 1-year, and 5-year follow-ups, respectively. MACE rates were 15.0%, 34.2%, and 50.9%. The VE/VCO2 slope was a significant predictor of MACE at all intervals. A VE/VCO2 slope >38.95 increased the risk of MACE by 2.49-fold at 3 months and 1.81-fold at 1 year (both < 0.001). A slope > 37.35 increased the 5-year MACE risk by 1.75-fold ( = 0.002). (4) Conclusions: The VE/VCO2 slope is a significant submaximal CPET predictor of MACE in patients post-acute decompensated HF for both short- and long-term outcomes.
(1) 背景：心力衰竭（HF）会导致功能残疾和重大心血管事件（MACE）。心肺运动试验（CPET）是评估有氧运动能力和预后分层的金标准。本研究旨在评估急性失代偿性HF患者出院前的CPET变量，并确定具有预后价值的次极量CPET变量。(2) 方法：在台湾的一家三级中心进行了一项回顾性队列研究。分析了首次失代偿性HF发作存活且出院前接受CPET检查的患者（2017年2月至2023年1月）。随访至发生MACE或行政审查（最长5年）。Cox回归确定了MACE的显著预测因素。(3) 结果：该研究分别纳入了3个月、1年和5年随访期的553例、485例和267例患者。MACE发生率分别为15.0%、34.2%和50.9%。在所有随访期，VE/VCO2斜率都是MACE的显著预测因素。VE/VCO2斜率>38.95时，3个月时MACE风险增加2.49倍，1年时增加1.81倍（均P<0.001）。斜率>37.35时，5年MACE风险增加1.75倍（P = 0.002）。(4) 结论：对于急性失代偿性HF后的患者，无论短期还是长期结局，VE/VCO2斜率都是MACE的显著次极量CPET预测因素。
