Prognostic Value of Cardiopulmonary Exercise Test Parameters in Ventricular Assist Device Therapy

Purpose Cardiopulmonary exercise test parameters are among the best prognosticators for medically managed advanced heart failure. However, the prognostic value of pre & post-implantation CPET parameters in LVAD therapy is unclear and is evaluated in this study. Methods Adult patients who were implanted with an LVAD and underwent CPET during the pre and/or post-implantation period were included to the study. Five parameters were derived from each CPET: vO2max, oxygen uptake efficiency slope (OUES), vE/vCO2min, vE/vCO2max and vE/vCO2 Slope. The independent predictive relationship between CPET parameters and clinical outcomes was evaluated with multivariate analysis. Results Pre & post-implantation CPET cohorts included 191 and 122 patients respectively (Table 1). Among pre-implantation CPET parameters: vO2max was an independent predictor of in-hospital mortality; vO2max and OUES were independent predictors of 1-year, 3-year and 5-year mortality, whereas vE/vCO2min and vE/vCO2 Slope were independent predictors of 5-year mortality (p .05). Among post-implantation CPET parameters: vO2max was an independent predictor of 5-year mortality, while vE/vCO2min and vE/vCO2max were independent predictors of 3-year mortality (p Conclusion CPET parameters derived from pre and post-implantation exercise tests have high predictive value for long-term outcomes in LVAD therapy. Except vO2max, CPET parameters' predictive capacity for early post-implantation outcomes appears to be limited.