Prediction of mortality by VE/VCO2 slope in heart failure: A metanalysis of published data

POGGIO R; COHEN ARAZI H; MIRIUKA SG

Orlando, USA

Congreso; American Heart Association Scientific Sessions; 2009

AHA

Background: PeakVO2 has been traditionally used for prognostic evaluation in heart failure. In the past years VE/VCO2 slope has been shown to be similar or even superior in many studies. We perform a systematic review and a meta-analysis of diagnostic studies of VE/VCO2 slope in order to assess its ability to predict cardiovascular events in heart failure. Methods and Results: We searched the published literature in PubMed and ISI Web of Science for VE/VCO2 slope in heart failure. We performed a systematic review and a meta-analysis of diagnostic studies with those papers that fulfilled the selection criteria. Endpoints were serious cardiovascular events defined as death or the combined end-point of death, ventricular assist device implantation or heart transplant. We performed a sub-analysis with those papers that provide enough data to compare prognostic ability of VE/VCO2 slope and PeakVO2. We found 491 papers potentially relevant, and based on our search and selection criteria we selected 12 studies. We found no heterogeneity and no evidence of publication bias. Diagnostic odds ratio and area under the curve for serious cardiovascular events were 5.02 (95%CI: 4.06-6.21) and 0.75 (95%CI: 0.72-0.78), respectively. Six studies provided data to compare VE/VCO2 slope and PeakVO2. Both variables performed similar, although VE/VCO2 showed a trend to superiority. Conclusions: In this meta-analysis, VE/VCO2 slope shows a reasonable ability to predict serious cardiovascular events in heart failure, at least as effective as PeakVO2.