Article

Ventilatory efficiency decreases with age. This study aimed to
investigate the prognostic significance and cut-off value of the minute
ventilation/carbon dioxide production (VE/VCO2) slope according to age in
patients with heart failure. Methods and results We analysed 1501 patients with
heart failure from our observational cohort who performed maximal symptom-limited
cardiopulmonary exercise testing and separated them into three age groups (</=55
years, 56-70 years and >/=71 years) in total and according to the three ejection
fraction categories defined by European Society of Cardiology guidelines. The
endpoint was set as heart failure events, hospitalisation for heart failure or
death from heart failure. The VE/VCO2 slope increased with age. During the median
follow-up period of 4 years, 141 heart failure (9%) events occurred. In total,
univariate Cox analyses showed that the VE/VCO2 slope (cont.) was significantly
related to heart failure events, while on multivariate analysis, the prognostic
significance of the VE/VCO2 slope (cont.) was poor, accompanied by a significant
interaction with age ( P < 0.0001). The cut-off value of the VE/VCO2 slope
increased with the increase in age in not only the total but also the
sub-ejection fraction categories. Multivariate analyses with a stepwise method
adjusted for estimated glomerular filtration rate, peak oxygen consumption,
atrial fibrillation and brain natriuretic peptide, showed that the predictive
value of the binary VE/VCO2 slope separated by the cut-off value varied according
to age. There was a tendency for the prognostic significance to increase with age
irrespective of ejection fraction. Conclusion - The prognostic significance and
cut-off value of the VE/VCO2 slope may increase with advancing age.

Langue : ANGLAIS