Prognostic Impact of Peak Oxygen Uptake and Heart Rate Reserve in Patients After Off-pump Coronary Artery Bypass Grafting

Overview

Journal Clin Cardiol

Specialty Cardiology & Vascular Diseases

Date 2021 Feb 26

PMID 33634477

Citations 1

Authors

Abidan Abulimiti

Miho Nishitani-Yokoyama

Kazunori Shimada

Mitsuhiro Kunimoto

Tomomi Matsubara

Kei Fujiwara

Tatsuro Aikawa

Shohei Ouchi

Yurina Sugita

Kosuke Fukao

Tomoyasu Kadoguchi

Tetsuro Miyazaki

Akie Shimada

Taira Yamamoto

Tetsuya Takahashi

Toshiyuki Fujiwara

Tohru Asai

Atsushi Amano

Hiroyuki Daida

Tohru Minamino

Affiliations

Soon will be listed here.

Abstract

Background: Peak oxygen uptake (peak VO ) and heart rate reserve (HRR) are independent prognostic markers of cardiovascular disease. However, the impact of peak VO and HRR on long-term prognosis after off-pump coronary artery bypass grafting (OP-CABG) remains unclear.

Hypothesis: To determine the prognostic impact of peak VO and HRR in patients after OP-CABG.

Results: We enrolled 327 patients (mean age, 65.1 ± 9.3 years; male, 80%) who underwent OP-CABG and participated in early phase II cardiac rehabilitation. All participants underwent cardiopulmonary exercise testing (CPET) at the beginning of such rehabilitation. Overall, 48 (14.6%) patients died during the median follow-up period of 103 months. The non-survivor had significantly lower levels of peak VO (10.6 ± 0.5 vs. 13.7 ± 0.2 ml/kg/min, p < .01) and HRR (24.2 ± 1.8 vs. 32.7 ± 0.8 beats/min, p < .01) than the survivor. In both groups, peak VO significantly correlated with HRR (p < .01). Moreover, patients were divided into four groups according to the peak VO and HRR levels for predicting total mortality. The low-peak VO /low-HRR group had a significantly higher mortality risk than the other groups (hazards ratio, 5.61; 95% confidence interval, 2.59-12.16; p < .01). After adjusted the confounding factors, peak VO and HRR were independently associated with total mortality (both p < .05).

Conclusions: HRR is a simple parameter of CPET and an important prognostic marker for the risk stratification of total mortality even in patients with low-peak VO after OP-CABG.

Citing Articles

Prognostic impact of peak oxygen uptake and heart rate reserve in patients after off-pump coronary artery bypass grafting.

Abulimiti A, Nishitani-Yokoyama M, Shimada K, Kunimoto M, Matsubara T, Fujiwara K Clin Cardiol. 2021; 44(4):580-587.

PMID: 33634477 PMC: 8027571. DOI: 10.1002/clc.23579.

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