Information de reference pour ce titreAccession Number: | 01337494-201209000-00007.
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Author: | Swank, Ann M. PhD; Horton, John MS; Fleg, Jerome L. MD; Fonarow, Gregg C. MD; Keteyian, Steven PhD; Goldberg, Lee MD, MPH; Wolfel, Gene MD; Handberg, Eileen M. PhD; Bensimhon, Dan MD; Illiou, Marie-Christine PhD; Vest, Marianne MA, RN, CTTS; Ewald, Greg MD; Blackburn, Gordon PhD; Leifer, Eric PhD; Cooper, Lawton MD; Kraus, William E. MD; and for the HF-ACTION Investigators
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Institution: | From the Exercise Physiology Laboratory University of Louisville, Louisville, KY (A.M.S.); Duke Clinical Research Institute, Durham, NC (J.H.); Division of Cardiovascular Sciences, (J.L.F., L.C.) and Office of Biostatistics Research, (E.L.), National Heart, Lung, and Blood Institute, Bethesda, MD; Ahmanson UCLA Cardiomyopathy Center, Los Angeles, CA (G.C.F.); Division of Cardiovascular Medicine, Department of Medicine, Henry Ford Hospital, Detroit, MI (S.K.); University of Pennsylvania, Philadelphia, PA (L.G.); Division of Cardiology, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO (G.W.); Division of Cardiovascular Medicine, University of Florida, Gainesville, FL (E.M.H.); LeBauer Cardiovascular Research Foundation, Greensboro, NC (D.B.); APHP Corentin Celton, Cardiac Rehabilitation Department, Issy les Moulineaux, France (M-C.I); University Hospitals Case Medical Center, Cleveland, OH (M.V.); Division of Cardiology, Washington University School of Medicine, St. Louis, MO (G.E.); Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland OH (G.B.); Department of Medicine, Duke University School of Medicine, Durham, NC (W.E.K.).
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Title: | |
Source: | Circulation: Heart Failure. 5(5):579-585, September 2012.
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Abstract: | Background-: The prognostic ability of a single measurement of peak oxygen uptake (VO2) is well established in patients with chronic heart failure. The relation between a change in peak VO2 and clinical outcomes is not well defined.
Methods and Results-: This investigation determined whether an increase in peak VO2 was associated with a lower risk of the primary end point of time to all-cause mortality or all-cause hospitalization and 3 secondary end points. In Heart Failure and a Controlled Trial to Investigate Outcomes of Exercise Training, an exercise training trial for patients with systolic heart failure, cardiopulmonary exercise tests were performed at baseline and [almost equal to]3 months later in 1620 participants. Median peak VO2 in the combined sample increased from 15.0 (11.9-18.0 Q1-Q3) to 15.4 (12.3-18.7 Q1-Q3) mL[middle dot]kg-1[middle dot]min-1. Every 6% increase in peak VO2, adjusted for other significant predictors, was associated with a 5% lower risk of the primary end point (hazard ratio=0.95; CI=0.93-0.98; P<0.001); a 4% lower risk of the secondary end point of time to cardiovascular mortality or cardiovascular hospitalization (hazard ratio=0.96; CI=0.94-0.99; P<0.001); an 8% lower risk of cardiovascular mortality or heart failure hospitalization (hazard ratio=0.92; CI=0.88-0.96; P<0.001); and a 7% lower all-cause mortality (hazard ratio=0.93; CI=0.90-0.97; P<0.001).
Conclusions-: Among patients with chronic systolic heart failure, a modest increase in peak VO2 over 3 months was associated with a more favorable outcome. Monitoring the change in peak VO2 for such patients may have benefit in assessing prognosis.
Clinical Trial Registration-: URL: http://www.clinicaltrials.gov- ouverture dans une nouvelle fenêtre. Unique identifier: NCT00047437.
(C) 2012 American Heart Association, Inc.
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Author Keywords: | exercise testing; heart failure; peak oxygen uptake.
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Language: | English.
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Document Type: | Original Articles.
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Journal Subset: | Clinical Medicine.
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ISSN: | 1941-3289
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NLM Journal Code: | 101479941
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DOI Number: | https://dx.doi.org/10.1161/CIRCH...- ouverture dans une nouvelle fenêtre
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