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Clinical Utility of the Cardiorespiratory Optimal Point in Patients with Heart Failure
dc.contributor.author | Kroesen, Sophie H. | |
dc.contributor.author | Bakker, Esmée A. | |
dc.date.accessioned | 2023-11-29T11:17:27Z | |
dc.date.available | 2023-11-29T11:17:27Z | |
dc.date.issued | 2023-10 | |
dc.identifier.citation | Medicine & Science in Sports & Exercise 55(10):p 1727-1734, October 2023 [DOI: 10.1249/MSS.0000000000003206] | es_ES |
dc.identifier.uri | https://hdl.handle.net/10481/85920 | |
dc.description.abstract | Introduction We assessed the cardiorespiratory optimal point (COP)—the minimal V̇E/V̇O2 in a given minute of an incremental cardiopulmonary exercise test—in patients with heart failure (HF) and aimed to determine 1) its association with patient and disease characteristics, 2) changes after an exercise-based cardiac rehabilitation program (CR), and 3) the association with clinical outcomes. Methods We studied 277 HF patients (67 (58–74) yr, 30% female, 72% HF with restricted ejection fraction) between 2009 and 2018. Patients participated in a 12- to 24-wk CR program, and COP was assessed pre- and post-CR. Patient and disease characteristics and clinical outcomes (mortality and cardiovascular-related hospitalization) were extracted from patient files. The incidence of clinical outcomes was compared across COP tertiles (low, <26.0; moderate, 26.0–30.7; high, >30.7). Results Median COP was 28.2 (24.9–32.1) and was reached at 51% ± 15% of V̇O2peak. Lower age, female sex, higher body mass index, the absence of a pacemaker or the absence of chronic obstructive pulmonary disease, and lower N-terminal prohormone brain natriuretic peptide concentrations were associated with a lower COP. Participation in CR reduced COP (−0.8; 95% confidence interval, −1.3 to −0.3). Low COP had a reduced risk (adjusted hazard ratio, 0.53; 95% confidence interval, 0.33–0.84) for adverse clinical outcomes as compared with high COP. Conclusions Classic cardiovascular risk factors are associated with a higher, more unfavorable, COP. CR-based exercise training reduces COP, whereas a lower COP is associated with a better clinical prognosis. As COP can be established during a submaximal exercise test, this may offer novel risk stratification possibilities for HF care programs. | es_ES |
dc.description.sponsorship | Eurostars Grant (E!114585) | es_ES |
dc.language.iso | eng | es_ES |
dc.publisher | Wolters Kluwer Health | es_ES |
dc.rights | Atribución 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | * |
dc.subject | Cardiopulmonary exercise testing | es_ES |
dc.subject | Cardiac rehabilitation | es_ES |
dc.subject | Ventilatory efficiency | es_ES |
dc.subject | Cardiovascular Risk | es_ES |
dc.subject | Physical fitness | es_ES |
dc.title | Clinical Utility of the Cardiorespiratory Optimal Point in Patients with Heart Failure | es_ES |
dc.type | journal article | es_ES |
dc.rights.accessRights | open access | es_ES |
dc.identifier.doi | 10.1249/MSS.0000000000003206 | |
dc.type.hasVersion | VoR | es_ES |