Peak oxygen uptake in relation to total heart volume discriminates heart failure patients from healthy volunteers and at
- PDF / 1,183,869 Bytes
- 9 Pages / 595.276 x 793.701 pts Page_size
- 55 Downloads / 136 Views
RESEARCH
Open Access
Peak oxygen uptake in relation to total heart volume discriminates heart failure patients from healthy volunteers and athletes Henrik Engblom1, Katarina Steding1, Marcus Carlsson1, Henrik Mosén1, Bo Hedén1, Torsten Buhre2, Björn Ekmehag3, Håkan Arheden1*
Abstract Background: An early sign of heart failure (HF) is a decreased cardiac reserve or inability to adequately increase cardiac output during exercise. Under normal circumstances maximal cardiac output is closely related to peak oxygen uptake (VO2peak) which has previously been shown to be closely related to total heart volume (THV). Thus, the aim of this study was to derive a VO2peak/THV ratio and to test the hypothesis that this ratio can be used to distinguish patients with HF from healthy volunteers and endurance athletes. Thirty-one patients with HF of different etiologies were retrospectively included and 131 control subjects (60 healthy volunteers and 71 athletes) were prospectively enrolled. Peak oxygen uptake was determined by maximal exercise test and THV was determined by cardiovascular magnetic resonance. The VO2peak/THV ratio was then derived and tested. Results: Peak oxygen uptake was strongly correlated to THV (r2 = 0.74, p < 0.001) in the control subjects, but not for the patients (r2 = 0.0002, p = 0.95). The VO2peak/THV ratio differed significantly between control subjects and patients, even in patients with normal ejection fraction and after normalizing for hemoglobin levels (p < 0.001). In a multivariate analysis the VO2peak/THV ratio was the only independent predictor of presence of HF (p < 0.001). Conclusions: The VO2peak/THV ratio can be used to distinguish patients with clinically diagnosed HF from healthy volunteers and athletes, even in patients with preserved systolic left ventricular function and after normalizing for hemoglobin levels.
Introduction Heart failure (HF) is a complex syndrome associated with a variety of etiologies and clinical presentations [1] which implies a major diagnostic challenge. The accuracy of diagnosis by clinical means alone is often inadequate [2,3]. According to the definition of HF, patients should exhibit typical symptoms or signs such as breathlessness or fatigue at rest or during exercise, pulmonary congestion or ankle swelling, and objective evidence of cardiac dysfunction at rest [1]. However, ACC/AHA have identified 4 stages (A-D) with emphasis on the evolution and progression of HF, where stage A defines patients who are at high risk for developing HF but has no structural disorder of the heart and no signs or * Correspondence: [email protected] 1 Dept of Clinical Physiology, Lund University and Skåne University Hospital, Lund, Sweden Full list of author information is available at the end of the article
symptoms of HF [4]. Thus, there is a need for diagnostic methods that can objectify early signs of decreased cardiac performance in order to optimize management and treatment to prevent or delay progression of the disease and consequently improve patient prognosis. C
Data Loading...
