| Title: | Impact of High Respiratory Exchange Ratio During Submaximal Exercise on Adverse Clinical Outcome in Heart Failure |
| Authors: | Kakutani, Naoya Browse this author |
| Fukushima, Arata Browse this author →KAKEN DB |
| Yokota, Takashi Browse this author →KAKEN DB |
| Katayama, Takashi Browse this author |
| Nambu, Hideo Browse this author |
| Shirakawa, Ryosuke Browse this author |
| Maekawa, Satoshi Browse this author |
| Abe, Takahiro Browse this author |
| Takada, Shingo Browse this author →KAKEN DB |
| Furihata, Takaaki Browse this author →KAKEN DB |
| Ono, Kota Browse this author |
| Okita, Koichi Browse this author →KAKEN DB |
| Kinugawa, Shintaro Browse this author →KAKEN DB |
| Anzai, Toshihisa Browse this author →KAKEN DB |
| Keywords: | Anaerobic threshold |
| Cardiopulmonary exercise testing |
| Heart failure |
| Respiratory exchange ratio |
| Submaximal exercise |
| Issue Date: | 2018 |
| Publisher: | The Japanese Circulation Society |
| Journal Title: | Circulation Journal |
| Volume: | 82 |
| Issue: | 11 |
| Start Page: | 2753 |
| End Page: | 2760 |
| Publisher DOI: | 10.1253/circj.CJ-18-0103 |
| Abstract: | Background: Oxygen uptake (V̇O2) at peak workload and anaerobic threshold (AT) workload are often used for grading heart failure (HF) severity and predicting all-cause mortality. The clinical relevance of respiratory exchange ratio (RER) during exercise, however, is unknown.Methods and Results: We retrospectively studied 295 HF patients (57±15 years, NYHA class I–III) who underwent cardiopulmonary exercise testing. RER was measured at rest; at AT workload; and at peak workload. Peak V̇O2 had an inverse correlation with RER at AT workload (r=−0.256), but not at rest (r=−0.084) or at peak workload (r=0.090). Using median RER at AT workload, we divided the patients into high RER (≥0.97) and low RER (<0.97) groups. Patients with high RER at AT workload were characterized by older age, lower body mass index, anemia, and advanced NYHA class. After propensity score matching, peak V̇O2 tended to be lower in the high-RER than in the low-RER group (14.9±4.5 vs. 16.1±5.0 mL/kg/min, P=0.06). On Kaplan-Meier analysis, HF patients with a high RER at AT workload had significantly worse clinical outcomes, including all-cause mortality and rate of readmission due to HF worsening over 3 years (29% vs. 15%, P=0.01). Conclusions: High RER during submaximal exercise, particularly at AT workload, is associated with poor clinical outcome in HF patients. |
| Rights: | https://creativecommons.org/licenses/by-nc-nd/4.0/ |
| Type: | article |
| URI: | http://hdl.handle.net/2115/76974 |
| Appears in Collections: | 北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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