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  • Title: VE/VCO2 slope and oxygen uptake efficiency slope in patients with coronary artery disease and intermediate peakVO2.
    Author: Van de Veire NR, Van Laethem C, Philippé J, De Winter O, De Backer G, Vanderheyden M, De Sutter J.
    Journal: Eur J Cardiovasc Prev Rehabil; 2006 Dec; 13(6):916-23. PubMed ID: 17143123.
    Abstract:
    BACKGROUND: Peak exercise oxygen uptake (peakVO2) is a widely used prognosticator. Novel spirometric parameters, less affected by submaximal performance, such as the rate of increase of minute ventilation per unit decrease of carbon dioxide production (VE/VCO2 slope) and the oxygen uptake efficiency slope (OUES) have recently been introduced. AIM: To evaluate the discriminative value of OUES, as compared to VE/VCO2 slope in patients with coronary artery disease (CAD) and intermediate peakVO2 values. METHODS AND RESULTS: Bicycle spiroergometry was applied in 214 patients with CAD (age 67+/-8 years, 85% men). OUES was strongly related to peakVO2 (r=0.79). New York Heart Association (NYHA) class, 6-min walking distance, N-terminal pro-brain natriuretic peptide (NT-proBNP), inflammatory markers, left ventricular (LV) volumes and ejection fraction were evaluated. NT-proBNP levels predicted independently VE/VCO2-slope and OUES. Patients with intermediate peakVO2 (12-18 ml/kg per min) and increased VE/VCO2-slope (> or = 35) had higher NYHA class, lower walking distance, higher NT-proBNP levels and higher LV volumes as compared to patients with a similar peakVO2 but lower VE/VCO2-slope. Similar findings were found for patients with intermediate peakVO2 and high OUES/kg (median value>15.3). CONCLUSION: In CAD patients, OUES was strongly correlated with peakVO2. Both VE/VCO2 slope and OUES were independently associated with NT-proBNP levels. Both VE/VCO2 slope and OUES/kg were able to identify a subgroup of patients with an intermediate peakVO2 that was characterized by advanced remodelling and a higher degree of neurohumoral activation.
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