Changes and prognostic value of cardiopulmonary exercise testing parameters in elderly patients undergoing cardiac rehabilitation: The EU-CaRE observational study
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Changes and prognostic value of cardiopulmonary exercise testing parameters in elderly patients undergoing cardiac rehabilitation : The EU-CaRE observational study. / Marcin, Thimo; Eser, Prisca; Prescott, Eva; Prins, Leonie F.; Kolkman, Evelien; Bruins, Wendy; Van Der Velde, Astrid E.; Gil, Carlos Penã; Iliou, Marie Christine; Ardissino, Diego; Zeymer, Uwe; Meindersma, Esther P.; Van't Hof, Arnoud W.J.; De Kluiver, Ed P.; Wilhelm, Matthias.
In: Plos One, Vol. 16, No. 8 August, e0255477, 2021, p. 1-13.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Changes and prognostic value of cardiopulmonary exercise testing parameters in elderly patients undergoing cardiac rehabilitation
T2 - The EU-CaRE observational study
AU - Marcin, Thimo
AU - Eser, Prisca
AU - Prescott, Eva
AU - Prins, Leonie F.
AU - Kolkman, Evelien
AU - Bruins, Wendy
AU - Van Der Velde, Astrid E.
AU - Gil, Carlos Penã
AU - Iliou, Marie Christine
AU - Ardissino, Diego
AU - Zeymer, Uwe
AU - Meindersma, Esther P.
AU - Van't Hof, Arnoud W.J.
AU - De Kluiver, Ed P.
AU - Wilhelm, Matthias
N1 - Publisher Copyright: © 2021 Public Library of Science. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Objective We aimed 1) to test the applicability of the previously suggested prognostic value of CPET to elderly cardiac rehabilitation patients and 2) to explore the underlying mechanism of the greater improvement in exercise capacity (peak oxygen consumption, VO2) after CR in surgical compared to non-surgical cardiac patients. Methods Elderly patients (?65 years) commencing CR after coronary artery bypass grafting, surgical valve replacement (surgery-group), percutaneous coronary intervention, percutaneous valve replacement or without revascularisation (non-surgery group) were included in the prospective multi-center EU-CaRE study. CPETs were performed at start of CR, end of CR and 1-year-follow-up. Logistic models and receiver operating characteristics were used to determine prognostic values of CPET parameters for major adverse cardiac events (MACE). Linear models were performed for change in peak VO2 (start to follow-up) and parameters accounting for the difference between surgery and non-surgery patients were sought. Results 1421 out of 1633 EU-CaRE patients performed a valid CPET at start of CR (age 73±5.4, 81% male). No CPET parameter further improved the receiver operation characteristics significantly beyond the model with only clinical parameters. The higher improvement in peak VO2 (25% vs. 7%) in the surgical group disappeared when adjusted for changes in peak tidal volume and haemoglobin. Conclusion CPET did not improve the prediction of MACE in elderly CR patients. The higher improvement of exercise capacity in surgery patients was mainly driven by restoration of haemoglobin levels and improvement in respiratory function after sternotomy.
AB - Objective We aimed 1) to test the applicability of the previously suggested prognostic value of CPET to elderly cardiac rehabilitation patients and 2) to explore the underlying mechanism of the greater improvement in exercise capacity (peak oxygen consumption, VO2) after CR in surgical compared to non-surgical cardiac patients. Methods Elderly patients (?65 years) commencing CR after coronary artery bypass grafting, surgical valve replacement (surgery-group), percutaneous coronary intervention, percutaneous valve replacement or without revascularisation (non-surgery group) were included in the prospective multi-center EU-CaRE study. CPETs were performed at start of CR, end of CR and 1-year-follow-up. Logistic models and receiver operating characteristics were used to determine prognostic values of CPET parameters for major adverse cardiac events (MACE). Linear models were performed for change in peak VO2 (start to follow-up) and parameters accounting for the difference between surgery and non-surgery patients were sought. Results 1421 out of 1633 EU-CaRE patients performed a valid CPET at start of CR (age 73±5.4, 81% male). No CPET parameter further improved the receiver operation characteristics significantly beyond the model with only clinical parameters. The higher improvement in peak VO2 (25% vs. 7%) in the surgical group disappeared when adjusted for changes in peak tidal volume and haemoglobin. Conclusion CPET did not improve the prediction of MACE in elderly CR patients. The higher improvement of exercise capacity in surgery patients was mainly driven by restoration of haemoglobin levels and improvement in respiratory function after sternotomy.
UR - http://www.scopus.com/inward/record.url?scp=85111872278&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0255477
DO - 10.1371/journal.pone.0255477
M3 - Journal article
C2 - 34343174
AN - SCOPUS:85111872278
VL - 16
SP - 1
EP - 13
JO - PLoS ONE
JF - PLoS ONE
SN - 1932-6203
IS - 8 August
M1 - e0255477
ER -
ID: 304173085