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• W2890979060 abstract "Introduction Heart failure (HF) is an increasingly recognized outcome in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D). Though cardiopulmonary exercise testing (CPET) serves as a prognostic tool in advanced HF, it is rarely used in ARVC/D due to perceived arrhythmia risk and limited data. We sought to determine the safety of CPET and demonstrate utility of Ve/VCO 2 slope in ARVC/D. Methods Using the Johns Hopkins ARVC/D registry, we retrospectively identified and analyzed 46 CPETs from 33 patients meeting 2010 Task Force Criteria. Each patient's most recent CPET was used to evaluate the association of normalized maximal oxygen uptake (peak VO 2 ) and ventilatory efficiency (Ve/VCO 2 slope) with transplant-free survival using Kaplan-Meier graphs and log-rank test. Baseline characteristics were compared between groups using Mann-Whitney U and Fisher exact tests. Results The majority of the 46 CPETs were performed without complications. Arrhythmia occurred infrequently and was asymptomatic: PVCs (n = 1), bigeminy (n = 1) and NSVT (n = 2). Normalized peak VO 2 (pVO 2 ) ranged from 9.7 to 54.8 mL/kg/min. Ve/VCO 2 slope ranged from 21.9 to 65.2. Baseline demographics including race, sex, comorbidities, age at diagnosis, and mutation did not differ among those with pVO 2 ≤14 (n = 8) vs pVO 2 >14 (n = 25) or Ve/VCO 2 slope ≥33 (n = 12) vs Ve/VCO 2 slope 2 ≤14 (13/24 (54%) vs. 8/8 (100%), P = 0.005) and in the group with Ve/VCO 2 slope≥33 (8/16 (50%) vs. 11/12 (92%), P = 0.005). Decreased transplant-free survival was demonstrated in patients with Ve/VCO 2 slope≥33 (hazard ratio 11.95, 95% CI 1.40-101.74, P = 0.023; Figure 1 ) but not in patients with pVO 2 ≤14 (hazard ratio 2.32, 95% CI 0.67-8.07, P = 0.186). Additionally, patients with higher Ve/VCO 2 slope tended to have more severe RV dysfunction by echo ( Figure 2 ). Conclusion In patients with ARVC/D, CPET is safe to perform. Additionally, Ve/VCO 2 slope may have utility in risk stratification in this predominantly RV disease." @default.
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• W2890979060 date "2018-08-01" @default.
• W2890979060 modified "2023-09-23" @default.
• W2890979060 title "Safety and Utility of Cardiopulmonary Exercise Testing in Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia" @default.
• W2890979060 doi "https://doi.org/10.1016/j.cardfail.2018.07.146" @default.
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