Author + information
- Takeshi Kitai,
- Chonyang Albert,
- Timothy Engelman,
- Justin Grodin and
- W.H. Wilson Tang
Background: Exercise intolerance is associated with poor outcomes in patients with heart failure (HF). The diminished peak-exercise cardiac output and impaired peripheral functions can contribute to reduced peak oxygen consumption (VO2) and higher VE/VCO2. Proportional pulse pressure (PPP), a ratio of pulse pressure and systolic blood pressure, is a surrogate for stroke volume. This study aimed to investigate relationships between PPP response to exercise and exercise capacity.
Methods and Results: A total of consecutive 1739 patients who underwent cardiopulmonary exercise testing were retrospectively reviewed. In our study cohorts (age: 53.2±15.1, male: 61.4%, ejection fraction: 45.5±19.2%, peak VO2: 20.0±8.9 ml/min/kg, VE/VCO2: 34.2±6.8), PPP was significantly increased during peak-exercise from baseline (47.1±9 vs 36.0±7.4%, P<0.001). Peak-exercise PPP was positively correlated with peak VO2 (ρ=0.38, P<0.001) and negatively correlated with VE/VCO2 (ρ=-0.29, P<0.001), while baseline PPP was not. There were 56 deaths during a median follow up of 320 days. Lower peak-exercise PPP was associated with increased mortality (quartile 1 vs 4, hazard ratio: 7.82, 95% CI: 1.87 to 32.8, P<0.001, Figure).
Conclusions: Peak-exercise PPP had better correlations with exercise capacity and there was a graded increase in risk for peak-exercise PPP and mortality. Our results highlight the importance of augmenting stroke volume during exercise in HF.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Making Progress in Understanding Heart Failure
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1123-276
- 2017 American College of Cardiology Foundation