Meyers J, Arena R, Dewey F, Bensimhon D, Abella J, Hsu L, Chase P, Guazzi M, Peberdy MA
This study set out to evaluate the predictive accuracy of a cardiopulmonary exercise test (CPX) score. Cardiopulmonary exercise test responses, including peak VO2, markers of ventilatory inefficiency, and hemodynamic responses are strong predictors of outcomes in patients with heart failure (HF). Seven hundred and ten patients with HF (resting left ventricular ejection fraction 33 +/- 14%) underwent CPX and were followed for cardiac-related mortality and separately for major cardiac events (death, hospitalization for HF, transplantation, left ventricular assist device implantation) for a mean of 29 months.
Cardiopulmonary exercise test score variables were weighted, and a multivariate score was derived. A summed score >15 was associated with an annual mortality rate of 27%, whereas a score <5 was associated with a mortality rate of 0.4%. The authors concluded that a multivariable score based on readily available CPX responses provides a simple and integrated method that powerfully predicts outcomes in patients with HF.
American Heart Journal 2008; 156: 1177 – 83