scholarly journals Calidad de vida en un adulto joven insuficiente cardíaco en Manta

2018 ◽  
Vol 1 (12) ◽  
Author(s):  
Yadira Flores ◽  
Karina Ortiz
Keyword(s):  
Heart Failure ◽  
Structural Damage ◽  
Hospital Admissions ◽  
Health Sector ◽  
Clinical History ◽  
Functional Class ◽  
Coronary Syndrome ◽  
Calidad De Vida ◽  
Insuficiencia Cardiaca ◽  
The Impact

El problema identificado por las autoras es la insuficiencia cardíaca de origen isquémico-necrótico, que es más frecuente en la actualidad en adultos jóvenes en pleno desenvolvimiento de su existencia, afectando todos los aspectos de calidad de vida, desde el punto de vista de la enfermedad, y sus afectaciones a nivel psicológico y social. El objetivo fue evaluar los tratamientos efectivos, aspectos físicos, psíquicos, sociales y económicos que influyen en un paciente adulto joven con insuficiencia cardiaca. La metodología utilizada fue el estudio de caso, se tomó como referencia la historia clínica de un paciente que inició tempranamente con síndrome coronario agudo, consecuentemente presentó deterioro de su función cardíaca y a pesar de los tratamientos asignados, ha incurrido en la progresión del daño estructural y funcional del miocardio.  Se utilizó como instrumento la historia clínica y exámenes complementarios. Los resultados no fueron los mejores, porque continuó la evolución natural de la enfermedad, pese al tratamiento instaurado por el impacto de diversos factores. Se concluyó que la atención de una patología tan compleja como la insuficiencia cardiaca en un hombre que inicio su enfermedad a los 40 años de edad, que tiene en la actualidad cinco décadas de vida, debió ser integral desde sus inicios, con la incorporación a equipos multidisciplinarios en el sector salud. Lo que incentiva a recomendar significativos ajustes en las políticas de salud, para tratar a estos grupos de pacientes que constituyen motivo de ingresos hospitalarios frecuentes en las casas de salud. Palabras clave: Atención integral de salud, aspectos psicológicos, aspectos socioeconómicos, sexualidad, clase funcional. Abstratc o sumary The problem identified by the authors is heart failure of ischemic-necrotic origin, which is currently more frequent in young adults who are in full development of their existence, affecting all aspects of their quality of life, from the point of view of view of the disease, and its effects at the psychological and social level. The objective was to evaluate the effective treatments, physical, psychic, social and economic aspects that influence a young adult patient with heart failure. The methodology used was the case study, the clinical history of a patient who started early with acute coronary syndrome was taken as a reference, consequently he presented deterioration of his cardiac function and despite the assigned treatments, he has incurred in the progression of the structural damage and functional myocardium The clinical history, complementary tests were used as an instrument. The results were not the best, because the natural evolution of the disease continued, despite the treatment established by the impact of various factors. It was concluded that the treatment of a pathology as complex as heart failure in a man who started his illness at 40 years of age and who currently has five decades of life, should have been comprehensive since its inception, with his incorporation into teams multidisciplinary in the health sector. This encourages us to recommend better adjustments in the health policies that are involved in treating these groups of patients that are a reason for frequent hospital admissions in health centers. Keys Words: Comprehensive health care, psychological aspects, socioeconomic aspects, sexuality, functional class. PARTICIPACIÓN EN LA PUBLICACIÓN: Autor: Yadira Flores, Cardiólogo. Co – Autores: Karina Ortiz, Cardiólogo.

scholarly journals Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Antonio Leon-Justel ◽  
Jose I. Morgado Garcia-Polavieja ◽  
Ana Isabel Alvarez-Rios ◽  
Francisco Jose Caro Fernandez ◽  
Pedro Agustin Pajaro Merino ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Admissions ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Secondary Outcome ◽  
Ventricular Ejection Fraction ◽  
Number Of Patients ◽  
Ed Visits ◽  
The Impact

Abstract Background Heart failure (HF) is a major and growing medical and economic problem, with high prevalence and incidence rates worldwide. Cardiac Biomarker is emerging as a novel tool for improving management of patients with HF with a reduced left ventricular ejection fraction (HFrEF). Methods This is a before and after interventional study, that assesses the impact of a personalized follow-up procedure for HF on patient’s outcomes and care associated cost, based on a clinical model of risk stratification and personalized management according to that risk. A total of 192 patients were enrolled and studied before the intervention and again after the intervention. The primary objective was the rate of readmissions, due to a HF. Secondary outcome compared the rate of ED visits and quality of life improvement assessed by the number of patients who had reduced NYHA score. A cost-analysis was also performed on these data. Results Admission rates significantly decreased by 19.8% after the intervention (from 30.2 to 10.4), the total hospital admissions were reduced by 32 (from 78 to 46) and the total length of stay was reduced by 7 days (from 15 to 9 days). The rate of ED visits was reduced by 44% (from 64 to 20). Thirty-one percent of patients had an improved functional class score after the intervention, whereas only 7.8% got worse. The overall cost saving associated with the intervention was € 72,769 per patient (from € 201,189 to € 128,420) and €139,717.65 for the whole group over 1 year. Conclusions A personalized follow-up of HF patients led to important outcome benefits and resulted in cost savings, mainly due to the reduction of patient hospitalization readmissions and a significant reduction of care-associated costs, suggesting that greater attention should be given to this high-risk cohort to minimize the risk of hospitalization readmissions.

scholarly journals Cardiovascular risk after hospitalisation for unexplained syncope and orthostatic hypotension

Heart ◽  
2017 ◽  
Vol 104 (6) ◽  
pp. 487-493 ◽  
Author(s):  
Ekrem Yasa ◽  
Fabrizio Ricci ◽  
Martin Magnusson ◽  
Richard Sutton ◽  
Sabina Gallina ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Orthostatic Hypotension ◽  
Cardiovascular Events ◽  
Hospital Admissions ◽  
Cox Regression ◽  
All Cause Mortality ◽  
Unexplained Syncope ◽  
The Impact

ObjectiveTo investigate the relationship of hospital admissions due to unexplained syncope and orthostatic hypotension (OH) with subsequent cardiovascular events and mortality.MethodsWe analysed a population-based prospective cohort of 30 528 middle-aged individuals (age 58±8 years; males, 40%). Adjusted Cox regression models were applied to assess the impact of unexplained syncope/OH hospitalisations on cardiovascular events and mortality, excluding subjects with prevalent cardiovascular disease.ResultsAfter a median follow-up of 15±4 years, 524 (1.7%) and 504 (1.7%) participants were hospitalised for syncope or OH, respectively, yielding 1.2 hospital admissions per 1000 person-years for each diagnosis. Syncope hospitalisations increased with age (HR, per 1 year: 1.07, 95% CI 1.05 to 1.09), higher systolic blood pressure (HR, per 10 mm Hg: 1.06, 95% CI 1.01 to 1.12), antihypertensive treatment (HR: 1.26, 95% CI 1.00 to 1.59), use of diuretics (HR: 1.77, 95% CI 1.31 to 2.38) and prevalent cardiovascular disease (HR: 1.59, 95% CI 1.14 to 2.23), whereas OH hospitalisations increased with age (HR: 1.11, 95% CI 1.08 to 1.12) and prevalent diabetes (HR: 1.82, 95% CI 1.23 to 2.70). After exclusion of 1399 patients with prevalent cardiovascular disease, a total of 473/464 patients were hospitalised for unexplained syncope/OH before any cardiovascular event. Hospitalisation for unexplained syncope predicted coronary events (HR: 1.85, 95% CI 1.49 to 2.30), heart failure (HR: 2.24, 95% CI 1.65 to 3.04), atrial fibrillation (HR: 1.84, 95% CI 1.50 to 2.26), aortic valve stenosis (HR: 2.06, 95% CI 1.28 to 3.32), all-cause mortality (HR: 1.22, 95% CI 1.09 to 1.37) and cardiovascular death (HR: 1.72, 95% CI 1.23 to 2.42). OH-hospitalisation predicted stroke (HR: 1.66, 95% CI 1.24 to 2.23), heart failure (HR: 1.78, 95% CI 1.21 to 2.62), atrial fibrillation (HR: 1.89, 95% CI 1.48 to 2.41) and all-cause mortality (HR: 1.14, 95% CI 1.01 to 1.30).ConclusionsPatients discharged with the diagnosis of unexplained syncope or OH show higher incidence of cardiovascular disease and mortality with only partial overlap between these two conditions.

Abstract P069: Heat, Heat Waves and Hospital Admissions in Indianapolis, Indiana

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Yi Wang
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Relative Risk ◽  
Heat Wave ◽  
Hospital Admissions ◽  
Heat Waves ◽  
Global Climate ◽  
Extreme Heat ◽  
Apparent Temperature ◽  
The Impact

Background: The association between heat and hospital admissions is well studied, but in Indiana where the regulatory agencies cites lack of evidence for global climate change, local evidence of such an association is critical for Indiana to mitigate the impact of increasing heat. Methods: Using a distributed-lag non-linear model, we studied the effects of moderate (31.7 °C or 90 th percentile of daily mean apparent temperature (AT)), severe (33.5 °C or 95 th percentile of daily mean apparent temperature (AT)) and extreme (36.4 °C or 99 th percentile of AT) heat on hospital admissions (June-August 2007-2012) for cardiovascular (myocardial infarction, myocardial infarction, heart failure) and heat-related diseases in Indianapolis, Indiana located in Marion County. We also examined the added effects of moderate heat waves (AT above the 90 th percentile lasting 2-6 days), severe heat waves (AT above the 95 th percentile lasting 2-6 days) and extreme heat waves (AT above the 99 th percentile lasting 2-6 days). In sensitivity analysis, we tested robustness of our results to 1) different temperature and lag structures and 2) temperature metrics (daily min, max and diurnal temperature range). Results: The relative risks of moderate heat, relative to 29.2°C (75 th percentile of AT), on admissions for cardiovascular disease (CVD), myocardial infarction (MI), heart failure (HF), and heat-related diseases (HD) were 0.98 (0.67, 1.44), 6.28 (1.48, 26.6), 1.38 (0.81, 2.36) and 1.73 (0.58, 5.11). The relative risk of severe heat on admissions for CVD, MI, HF, and HD were 0.93 (0.60, 1.43), 4.46 (0.85, 23.4), 1.30 (0.72, 2.34) and 2.14 (0.43, 10.7). The relative risk of extreme heat were 0.79 (0.26, 2.39), 0.11 (0.087, 1.32), 0.68 (0.18, 2.61), and 0.32 (0.005, 19.5). We also observed statistically significant added effects of moderate heat waves lasting 4 or 6 days on hospital admission for MI and HD and extreme heat waves lasting 4 days on hospital admissions for HD. Results were strengthened for people older than 65. Conclusions: Moderate heat wave lasting 4-6 days were associated with increased hospital admissions for MI and HD diseases and extreme heat wave lasting 4 days were associated with increased admissions for HD.

What impact do specialist and advanced-level nurses have on people living with heart failure compared to physician-led care? A literature review

2020 ◽  
pp. 174498712094679
Author(s):  
Dean A Anderson ◽  
Victoria Clemett
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Length Of Stay ◽  
Literature Review ◽  
Hospital Admissions ◽  
Self Care ◽  
Self Assessment ◽  
Advanced Level ◽  
The Impact

Background The inclusion of specialist nurses in multi-disciplinary teams is the current gold standard for care of people with heart failure (HF) in the UK; however, they remain underutilised in practice. Though existing systematic reviews favourably compare advanced nursing roles to physician-led care, none has focused solely on HF. Aim To investigate the impact of specialist and advanced nurse-led care on the clinical outcomes, quality of life and satisfaction of people with HF compared to physician-led care. Methods Literature review and narrative synthesis. Results This review included 12 studies and categorised their measured outcomes into five domains: mortality; hospital admissions and length of stay; HF diagnosis and management; quality of life and patient satisfaction; and finally, self-assessment and self-care. Five studies appraised as medium or low risk of bias suggest the impact of specialist and advanced-level nurses on people with HF to be broadly equivalent to physicians regarding mortality, hospital admissions and length of stay, while superior in terms of self-assessment and self-care behaviours. Conclusions There were too few studies of sufficient methodological quality to draw definitive conclusions. However, no evidence was found to suggest that nurse-led services are any less effective or safe than physician-led services.

P5003Reduced healthcare utilization in routine care initiators of empagliflozin with and without heart failure: interim analysis from the EMPagliflozin compaRative effectIveness and SafEty (EMPRISE) study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Pawar ◽  
E Patorno ◽  
A Deruaz-Luyet ◽  
K Brodovicz ◽  
A Ustyugova ◽  
...  
Keyword(s):  
Heart Failure ◽  
Propensity Score ◽  
Comparative Effectiveness ◽  
Interim Analysis ◽  
Treatment Initiation ◽  
Hospital Admissions ◽  
Routine Care ◽  
History Of ◽  
Hospital Days ◽  
The Impact

Abstract Background Empagliflozin (EMPA) reduced the risk of hospitalization for heart failure (HHF) (HR 0.65; 95% CI 0.50- 0.85) as demonstrated in the EMPA-REG OUTCOME trial in adults with type 2 diabetes (T2D) and established CV disease. However, the impact of EMPA treatment initiation on healthcare resource utilization (HCRU) in routine care in patients with history of heart failure (HF) or without history of HF remains unexplored. Purpose To compare HCRU among EMPA and dipeptidyl peptidase-4 inhibitor (DPP4i) initiators with and without HF history at time of treatment initiation. Methods We analyzed HCRU in the first two years after marketing of EMPA as part of EMPRISE, a non-interventional study on the comparative effectiveness, safety and HCRU of EMPA for T2D patients in routine care in two US commercial and Medicare claims datasets (08/2014–09/2016). We identified a 1:1 propensity-score-matched cohort of T2D patients ≥18 years initiating either EMPA or a DPP4i with and without baseline HF, and assessed the balance at baseline (period of 365 days) on ≥140 covariates including clinical, HCRU, and cost-related covariates using absolute standardized differences. We compared the risk of first all-cause hospitalization, risk of first HHF, risk of first emergency department (ED) visit, hospital length of stay (LOS), HF-related LOS, number of hospital admissions, HF-related hospital admissions, office visits, and ED visits in EMPA and DDP4i initiators. Results After propensity score matching, we identified 2,050 pairs with HF and 15,428 pairs without HF in the three datasets with mean follow-up of 5.2 and 5.4 months, respectively. All baseline characteristics were well balanced (with aSD<0.1). Compared to patients without HF history, patients with HF were older (65 vs 58), more commonly female (51% vs 46%), and had CV history (64% vs 19%) (Table 1). Compared to DPP4i, the hazard ratio (HR) for first hospitalization was 0.68 (95% CI: 0.56, 0.83) for EMPA initiators with HF, and 0.89 (95% CI: 0.80, 1.00) for initiators without HF. Risk of HF-related hospitalization and ED visit was lower in EMPA initiators with prior HF [HR=0.53 (0.38, 0.74) and HR=0.73 (0.58, 0.93), respectively] and without prior HF [HR=0.45 (0.27, 0.73) and HR=0.82 (0.70, 0.95), respectively]. Compared to DPP4i initiators, EMPA initiators with and without baseline HF had lower number of all hospital admissions [Incidence rate ratio (IRR)= 0.59 (0.50, 0.70) and IRR= 0.78 (0.71, 0.85), respectively] and HF-related hospital admissions [IRR=0.49 (0.37, 0.65) and IRR=0.34 (0.22, 0.53), respectively]. In-hospital days and HF-related in-hospital days per member per year (PMPY) in patients with and without HF history initiating EMPA were lower than DDP4i (Table 1). Conclusions Results observed in this interim analysis of EMPRISE showed reduction in overall HCRU as well as HF-related HCRU in both patients with and without heart failure (HF) initiating EMPA compared to DDP4i initiators. Acknowledgement/Funding This study was supported by a research grant to the Brigham and Women's Hospital from Boehringer-Ingelheim.

scholarly journals Impact of heart failure on stroke mortality and recurrence

Heart Asia ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. e011139 ◽  
Author(s):  
Tiberiu A Pana ◽  
Adrian D Wood ◽  
Jesus A Perdomo-Lampignano ◽  
Somsak Tiamkao ◽  
Allan B Clark ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Sector ◽  
Stroke Recurrence ◽  
Stroke Mortality ◽  
The Public ◽  
Risk Of Mortality ◽  
Reduction Strategies ◽  
Stroke Type ◽  
Risk Reduction Strategies ◽  
The Impact

ObjectiveWe aimed to examine the impact of heart failure (HF) on stroke mortality (in-hospital and postdischarge) and recurrence in a national stroke cohort from Thailand.MethodsWe used a large, insurance-based database including all stroke admissions in the public health sector in Thailand between 2004 and 2015. Logistic and Royston-Parmar regressions were used to quantify the effect of HF on in-hospital and long-term outcomes, respectively. All models were adjusted for age, sex and comorbidities and stratified by stroke type: acute ischaemic stroke (AIS) or intracerebral haemorrhage (ICH). Multistate models were constructed using flexible survival techniques to predict the impact of HF on the disease course of a patient with stroke (baseline-[recurrence]-death). Only first-ever cases of AIS or ICH were included in the multistate analysis.Results608 890 patients (mean age 64.29±13.72 years, 55.07% men) were hospitalised (370 527 AIS, 173 236 ICH and 65 127 undetermined pathology). There were 398 663 patients with first-ever AIS and ICH. Patients were followed up for a median (95% CI) of 4.47 years (4.45 to 4.49). HF was associated with an increase in postdischarge mortality in AIS (HR [99% CI] 1.69 [1.64 to 1.74]) and ICH (2.59 [2.07 to 3.26]). HF was not associated with AIS recurrence, while ICH recurrence was only significantly increased within the first 3 years after discharge (1.79 [1.18 to 2.73]).ConclusionsHF increases the risk of mortality in both AIS and ICH. We are the first to report on high-risk periods of stroke recurrence in patients with HF with ICH. Specific targeted risk reduction strategies may have significant clinical impact for mortality and recurrence in stroke.

scholarly journals mHealth interventions in the management of heart failure, ischaemic heart disease and hypertension: a systematic review and meta-analysis of randomised controlled trials

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P Indraratna ◽  
D Tardo ◽  
J Yu ◽  
K Delbaere ◽  
M Brodie ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Meta Analysis ◽  
Funding Source ◽  
Smartphone Applications ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
The Impact

Abstract Introduction Cardiovascular disease (CVD) remains the leading cause of death in the world. Mobile phones have become ubiquitous in most developed societies. Smartphone applications, telemonitoring and clinician-driven short message service (SMS) allow for novel methods in managing chronic cardiovascular conditions such as ischaemic heart disease, heart failure and hypertension. Purpose To evaluate the impact of mobile phone-based interventions (MPIs) on mortality, hospitalisations and blood pressure and body mass index (BMI) in patients diagnosed with either acute coronary syndrome, heart failure or hypertension. Methods A systematic review was conducted using seven electronic databases, identifying all randomised control trials (RCTs) featuring an MPI in the management of these conditions. Meta-analysis was performed by using standard analytical techniques. The odds ratio (OR) was used as a summary statistic. Results Twenty-six RCTs including 6,713 patients were identified. Of these 26 studies, 13 examined text messaging intereventions, 10 studied telemonitoring interventions and three described smartphone applications with other functions. Twelve studies were included for meta-analysis. In patients with heart failure (n=1683), MPIs were associated with a significantly lower rate of all-cause hospital admissions at six months (31% vs. 36%, OR 0.77, 95% CI 0.62–0.97, p=0.03, I2 = 0). A significant difference was also demonstrated for heart-failure admissions (14.0% vs. 18.5%, OR 0.69, 95% CI 0.48 to 0.98, p=0.04, I2 = 26%). There was no difference in mortality (10.4% vs. 11.6% p=0.45). In patients with hypertension, the difference in systolic BP was 4.3mmHg less in the intervention group (95% CI: −7.8 to −0.78 mmHg, p=0.02). Four studies examined medication compliance as an endpoint in patients with ischaemic heart disease, and all four demonstrated a significant difference favouring the MPI group (see table 1). However, due to variable quantification of compliance, meta-analysis was not possible. There was no significant difference in the change in BMI from four studies after six or more months (mean difference −0.46, 95% CI: −1.44 to 0.52, P=0.36). Conclusions The available data suggests MPIs may have a role as valuable adjuncts in the management of chronic CVD. Figure 1 Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Health and Medical Research Council (NHMRC)

scholarly journals Prevalencia de adolescentes embarazadas y su repercusión psicosocial atendidas en el hospital general jipijapa 2013

2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Margoth Elizabeth Villegas Chiriboga
Keyword(s):  
General Hospital ◽  
Adolescent Mothers ◽  
Social Issues ◽  
Clinical History ◽  
Control Area ◽  
Emotional Impact ◽  
Pregnant Adolescents ◽  
Calidad De Vida ◽  
The Impact ◽  
Hospital General

La presente investigación está relacionada la maternidad en las adolescentes como problemas de índole psicológico y social lo cual repercute en la calidad de vida. El Hospital General de Jipijapa no cuenta con programas preventivos y/o seguimientos de casos para saber el impacto o repercusiones que existe  en las madres adolescentes. El objetivo será establecer la prevalencia en adolescentes embarazadas y su repercusión psico-emocional para sugerir programas educativos y preventivos en las unidades educativas del Cantón Jipijapa. Tomando como población a todas las mujeres embarazadas que acuden al Hospital General Jipijapa y como muestra  las adolescentes embarazadas de 12 a 19 años de edad que asisten al control en el área de Ginecología desde Enero a Diciembre 2013. Se realizó un estudio retrospectivo, observacional de prevalencia transversal, se utilizó como instrumento de apoyo las historia clínica y encuestas; los resultados obtenidos en este estudio en el análisis e interpretación se la realizo a través de Excel, SPSS versión 22.  Palabras clave: Embarazo, Adolescentes, Tráumas Psicosociales  Abstract  summary: This research is related to teen motherhood as psychological problems and social issues which impact on the quality of life. The General Hospital jipijapa not have preventive and / or monitoring of cases to know the impact or implications that exists in adolescent mothers . The aim is to establish the prevalence in pregnant adolescents and their psycho - emotional impact to suggest education and prevention programs in the educational units jipijapa Canton. On the population to all pregnant women attending the General Hospital and as shown jipijapa pregnant adolescents 12 to 19 years old attending the control area Gynecology from January to December 2013. A retrospective, observational study was performed cross prevalence, was used as a tool to support the clinical history and surveys; the results obtained in this study is the analysis and interpretation conducted through Excel , SPSS version 22.

Abstract 3195: Is the Extent of Exercise VO 2 Oscillations Related to the Severity and Prognisis of Heart Failure?

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Takuya Taniguchi ◽  
Hiroshi Takaki ◽  
Motoaki Ibuki ◽  
Ryo Namikawa ◽  
Shogo Oishi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Admissions ◽  
Time Window ◽  
Low Frequency ◽  
Functional Class ◽  
Total Power ◽  
Consecutive Series ◽  
Exercise Tests ◽  
The Status ◽  
Low Frequency Power

Purpose : Exercise VE or VO 2 oscillation (OSC) as well as exercise hyperventilation is an ominous sign in patients with heart failure. However, unlike exercise hyperventilation that is readily evaluated by VE/VCO 2 slope, OSC have only been estimated in a qualitative manner (i.e., “present” or “absent”). We hypothesized that the extent of OSC may be related to the severity and prognosis of heart failure. Methods : From a consecutive series of >4700 cardiopulmonary bicycle exercise tests for recent 5.5 years, we examined the presence of OSC both by visual inspection and by our previously developed method where we estimated Ratio (Low frequency power/Total power) indicative of abnormal slow VO2 OSC (0.5–1.25 cycle/min) by repeating FFT power spectrum analysis (4-min time-window, overlapping every 30 sec). Results : We found VO 2 OSC (defined as Ratio >34.2%) in 175 patients, who were grouped by a median split into Group-H with moderate-to-pronounced OSC (Ratio >42, n=88) and Group-L with mild OSC (Ratio <42, n=87). Compared with Group-L, Group-H had lower peak VO 2 (17.5 ± 4.4 vs 20.9 ± 4.4 ml/min/kg, p< 0.0001) and exhibited higher VE/VCO 2 slope (38.3 ± 12.4 vs 32.5±5.7, p=0.0001), BNP level (308 ± 306 vs 172 ± 144 pg/ml, p<0.001), and NYHA functional class (1.9 ± 0.7 vs 1.6 ± 0.6, p=0.006). During the median follow-up period of 1093 days, cardiac deaths and hospital admissions for heart failure more frequently occurred in Group-H than in Group-L (see Figure ). Conclusions : The data indicate that the more pronounced the exercise VO 2 oscillations, the more severe the status of heart failure. Moderate-to-pronounced forms of exercise VO 2 oscillations predict an even poorer prognosis.

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