Optimized Peak VO2 in Predicting Advanced HF

Chang Gung Medical Foundation

Status: Completed

Conditions: Morality; Transplant; Failure, Heart; Heart Failure

Treatments: Diagnostic Test: cardiopulmonary exercise test

Study type: Observational

Funder types: Other

Identifiers

NCT05212649

202001285B0D001

Details and patient eligibility

About

The ability and timely selection of severe heart failure (HF) patients for cardiac transplantation and advanced HF therapy is challenging. Peak VO2 by cardiopulmonary exercise test (CPET) was used for transplant listing. This study aimed to reassess the prognostic significance of peak VO2 and to compare that with the Heart Failure Survival Score in the current optimized novel guideline-directed medical therapy (GDMT).

Full description

Investigators retrospectively collected acute HF patients discharged alive from the hospital. Investigators divided participants into more-GDMT (≥2 kinds) and few-GDMT (<2 kinds) groups and compared the prognostic significance of peak VO2 and HFSS for combined all-cause mortality and urgent cardiac transplantation.

Enrollment: 377 patients

Sex: All

Ages: 20 to 90 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• acute HF patients with reduced ejection fraction (left ventricular ejection fraction, LVEF <=40%) and discharged alive from the hospital
• patients with age >= 20 years of age
• patients who performed cardiopulmonary exercise test (CPET) within one month after discharge
• patients with serum B-type natriuretic peptide (BNP) level >100 pg/mL.

Exclusion criteria

• patients with estimated survival time < 6 months
• patients who could not tolerate exercise test due to muscular-skeletal disorder or other reason
• patients who had severe valvular heart disease.

Trial design

377 participants in 2 patient groups

More-GDMT

Description:

Baseline guideline-directed medications therapy (GDMT), including angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blocker (ARB), beta-blockers, mineralocorticoid receptor antagonist (MRA), and angiotensin receptor neprilysin inhibitor (ARNI) were documented at discharge. More-GDMT group was defined as patient population received GDMT \>=2 kinds of above medications.

Treatment:

Diagnostic Test: cardiopulmonary exercise test

Few-GDMT group

Description:

Baseline guideline-directed medications therapy (GDMT), including angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blocker (ARB), beta-blockers, mineralocorticoid receptor antagonist (MRA), and angiotensin receptor neprilysin inhibitor (ARNI) were documented at discharge. Few GDMT-group was defined as patients who received GDMT \< 2 kinds of the above medications.

Treatment:

Diagnostic Test: cardiopulmonary exercise test