Author + information
- António Amadeu Valentim Gonçalves,
- Tiago Pereira-da-Silva,
- Rui Soares,
- Joana Feliciano,
- Rita Ilhão Moreira and
- Rui Cruz Ferreira
Atrial fibrillation (AF) is associated with increasing mortality in Heart Failure patients. Whether AF patients can be precisely stratified by cardiopulmonary exercise test cut-offs for heart transplantation (HT) selection is not established.
Prospective evaluation of 274 consecutive patients with left ventricular ejection fraction ≤ 40%. The primary endpoint was a composite of cardiac death, urgent HT or the need for mechanical circulatory support in 1-year follow-up. The primary endpoint was analysed by several CPET parameters for the highest area under the curve. The guideline recommended cut-off value of peak VO2 (≤ 12 ml/kg/min) and VE/VCO2 slope (> 35) for HT selection were compared for positive and negative predictive value (PPV and NPV, respectively) in AF and sinus rhythm (SR) patients. Patients with elective HT during the follow-up period were excluded from the analysis.
There were 51 patients in the AF group and 223 in the SR group. Primary outcome was more frequent in the AF group (17.6% vs 8.1%, p 0.038). Table 1 represents the area under the curve of each parameter analysed. The cut-off value of peak VO2 showed a PPV of 100% and an NPV of 95.5% for the primary outcome in the AF group, while the cut-off value for VE/VCO2 slope showed lower values of PPV (33.3%) and similar NPV (92.3%).
Despite the fact that AF carries a worse prognosis for heart failure patients, a peak VO2 ≤ 12 ml/kg/min can precisely stratify this high-risk group with a higher PPV than VE/VCO2 slope.
Poster Hall, Hall F
Sunday, March 17, 2019, 3:45 p.m.-4:30 p.m.
Session Title: Heart Failure and Cardiomyopathies: Clinical 4
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1284-558
- 2019 American College of Cardiology Foundation