Heart 1997;78:572-576 ( December )

Comparison of the long term prognostic value of peak exercise oxygen pulse and peak oxygen uptake in patients with chronic heart failure

A Cohen-Solal,^a P Barnier,^a F Pessione,^b P Seknadji,^a D Logeart,^a T Laperche,^a R Gourgon^a

^a Service de Cardiologie, Hôpital Beaujon, Clichy, France, ^b Département d'Epidémiologie, Hôpital Beaujon, Clichy, France

Correspondence to: Pr A Cohen-Solal, Service de CardiologieHôpital Beaujon, 100 Boulevard du General Leclerc, 92110 Clichy, France.

Accepted for publication 9 September 1997

ObjectiveTo evaluate the ratio of peak oxygen consumption to peak heart rate (peak oxygen pulse) as a predictor of long term prognosis in chronic heart failure.
Patients and setting178 consecutive heart failure patients recruited to the cardiology department of a tertiary referral centre between 1986 and 1993. 
DesignBicycle ergometry with measurement of respiratory exchange. Mean (SD) follow up was 32 (25) months.
ResultsPatients who died had a lower peak oxygen consumption (16.0 (5.5) v 18.0 (5.5) ml/min/kg, p = 0.05), lower indexed peak oxygen consumption (52 (14) v 60 (16)%, p = 0.006) but similar peak oxygen pulse (8.4 (2.6) v 8.4 (3.0) ml/beat, NS). The following variables were associated with a good long term prognosis: New York Heart Association class II, non-ischaemic heart failure, peak oxygen consumption  17 ml/min/kg, indexed peak oxygen consumption > 63%. Peak oxygen pulse did not have predictive value. Only indexed peak oxygen consumption remained an independent predictor of survival in multivariate analysis.
ConclusionsPeak oxygen pulse has lower prognostic value than peak oxygen consumption, especially when the latter is indexed to predicted values.

Keywords: prognosis;  oxygen consumption;  oxygen pulse;  exercise;  heart failure

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© 1997 by Heart
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