Ventricular arrhythmias not meeting criteria for terminating cardiopulmonary exercise testing stratify prognosis and disease severity in heart failure of preserved, midrange, and reduced ejection fraction

Background Continued high mortality in heart failure patients indicates the need for additional methods of risk stratification and phenotyping. Hypothesis We hypothesized that ventricular arrhythmias that do not meet test‐termination criteria (non‐terminating ventricular arrhythmias [NTVA]) during c...

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Published in:Clinical cardiology (Mahwah, N.J.) N.J.), 2020-07, Vol.43 (7), p.698-705
Main Authors: Popovic, Dejana, Arena, Ross, Jakovljevic, Djordje, Ristic, Arsen, Guazzi, Marco
Format: Article
Language:English
Subjects:
Cardiac arrhythmia
cardiopulmonary exercise testing
Cardiovascular disease
Clinical Investigations
Ejection fraction
Etiology
Heart failure
Heart rate
HFmrEF
HFpEF
HFrEF
Hypertension
Mortality
Patients
prognosis
Pulmonary arteries
Software
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Summary:Background Continued high mortality in heart failure patients indicates the need for additional methods of risk stratification and phenotyping. Hypothesis We hypothesized that ventricular arrhythmias that do not meet test‐termination criteria (non‐terminating ventricular arrhythmias [NTVA]) during cardiopulmonary exercise testing (CPET) may help in phenotyping disease severity and prognosis in heart failure with reduced (HFrEF) and midrange (HFmrEF)/preserved (HFpEF) left ventricular ejection fraction (LVEF). Methods About 319 patients with heart failure (199 HFrEF; 80 HFmrEF; 41 HFpEF) underwent CPET. Tricuspid annular plane systolic excursion (TAPSE) and pulmonary artery systolic pressure (PASP) were measured by echocardiography. B‐type natriuretic peptide (BNP) at rest and peak exercise was also determined. The patients were tracked for primary (cardiac death) and secondary composite outcomes (all‐cause death, heart transplantation/left ventricular assist device implantation, hospitalization for cardiac reasons). Results Forty‐seven (15%) of the patients demonstrated NTVA during CPET, regardless of coronary artery disease prevalence. Patients without arrhythmias had a significantly higher LVEF (P 
ISSN:0160-9289
1932-8737
DOI:10.1002/clc.23367