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Titolo:
SERIAL EXERCISE TESTING AND PROGNOSIS IN SELECTED PATIENTS CONSIDEREDFOR CARDIAC TRANSPLANTATION
Autore:
GULLESTAD L; MYERS J; ROSS H; RICKENBACHER P; SLAUSON S; BELLIN D; VAGELOS R; FOWLER M;
Indirizzi:
STANFORD UNIV,MED CTR,SCH MED,FALK CARDIOVASC RES CTR STANFORD CA 96305 STANFORD UNIV,MED CTR,SCH MED,FALK CARDIOVASC RES CTR STANFORD CA 96305 UNIV HOSP,RIKSHOSP OSLO NORWAY
Titolo Testata:
The American heart journal
fascicolo: 2, volume: 135, anno: 1998,
parte:, 1
pagine: 221 - 229
SICI:
0002-8703(1998)135:2<221:SETAPI>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
CONGESTIVE-HEART-FAILURE; IDIOPATHIC DILATED CARDIOMYOPATHY; LEFT-VENTRICULAR DYSFUNCTION; OXYGEN-CONSUMPTION; PLASMA NOREPINEPHRINE; EJECTION FRACTION; MORTALITY; SURVIVAL; SECONDARY; CAPACITY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
32
Recensione:
Indirizzi per estratti:
Citazione:
L. Gullestad et al., "SERIAL EXERCISE TESTING AND PROGNOSIS IN SELECTED PATIENTS CONSIDEREDFOR CARDIAC TRANSPLANTATION", The American heart journal, 135(2), 1998, pp. 221-229

Abstract

Objectives This study sought to examine the predictive value of variables obtained from serial maximal exercise testing, echocardiography, and election fraction in patients referred as potential heart transplant candidates. Background Variables such as peak VO2, left ventriculardimensions, election fraction, and hemodynamic measurements are knownto predict prognosis in heart failure, but there are few data on the impact of serial measurements of these variables on subsequent mortality. Methods and Results Two hundred sixty-three ambulatory patients with severe heart failure referred as potential candidates for heart transplantation who underwent two exercise tests (mean 7.8 months apart) after optimal medical treatment were identified. At the same two time points, echocardiography was performed in 106 (37%) and election fraction was measured in 84 (30%). During a mean follow-up period of 3.9 +/- 0.1 years, 70 (25%) died and 45 (19%) underwent heart transplantation. Exercise capacity, peak exercise heart rate, and peak exercise systolic blood pressure achieved were all significantly higher among survivors compared with nonsurvivors. Among the survivors a slight increasein peak VO2 and ejection fraction were observed, but there were no significant differences in the changes of any of the measured variables between survivors and nonsurvivors. There were no significant differences in survival between patients with increased versus those with decreased peak VO2, left ventricular dimensions, or election fraction. Conclusion Although peak VO2, left ventricular dimensions, and election fraction predict survival, changes in these parameters do not add any prognostic information in patients with severe heart failure who have been stabilized with optimal medical treatment. Routine use of these procedures therefore does not seem to be warranted and should be performed only in the context of a specific clinical situation. Serial measurements of these parameters do not appear to be useful in the risk stratification of patients referred for heart transplantation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/11/20 alle ore 15:48:37