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Background: We hypothesized that exercise cardiac power (ECP) defined as a ratio of directly measured maximal oxygen (VO2max) uptake with peak systolic blood pressure (SBP) during exercise has prognostic utility in heart failure (HF) risk prediction.
Methods: Population-based cohort study with an average follow-up of 25 years from eastern Finland. About 1813 men at baseline participated in exercise stress test, had complete information on all risk factors and had 194 incident HF events.
Results: Age adjusted hazard ratio (HR) per unit increase (1 mL/mmHg) in ECP was 0.87(95% CI 0.82-0.92), which was minimally attenuated to 0.91(95% CI: 0.85-0.96) after further adjustment for established risk factors (resting systolic blood pressure, history of cardiovascular disease, smoking, diabetes, alcohol use, body mass index, renal function, serum LDL-c and left ventricular hypertrophy) and incident coronary events as a time varying covariate. In a comparison of extreme fourths of ECP levels, the corresponding HRs were 0.49 (95% CI: 0.31-0.79) for the maximally adjusted model. Addition of ECP to a model containing established risk factors did not significantly improve risk discrimination (C-index change=0.0008, P=0.26), but provided significant incremental improvement in risk reclassification (category-free net reclassification index 6.1%, P<0.001).
Conclusions: ECP provides a novel yet non-invasive measure for the prediction of incident HF.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: The Evolving World of LVADs, Transplant and Other Novel Discoveries
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1294-276
- 2017 American College of Cardiology Foundation