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Effects of age on aerobic capacity in heart failure patients under beta-blocker therapy: Possible impact in clinical decision-making?
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Abstract
Background: Heart failure (HF) is associated with impaired maximal aerobic capacity asindicated by decreases in peak oxygen uptake (peak VO2). Considering that aging by itself has a negative effect on this variable, the evaluation of maximum capacity is often questioned because current predicted peak VO2 is based on subjects without heart disease or b-blocker therapy. In contrast, if decline in predicted and attained peak VO2 were age-related, proportionally, loss ofaerobic function (predicted peak VO2, %) would remain stable over time in these patients. The purpose of this investigation is to assess the effects of age on peak VO2 in HF patients taking b-blockers.\
Methods: We retrospectively evaluated 483 (132 female) patients (aged 20–88 years, LVEF31 ± 11%) with non-ischemic (n = 362), ischemic (n = 74) and Chagas-related HF (n = 47) who had been submitted to an incremental cardiopulmonary exercise testing on a motorized treadmill. Linear regression was used to develop the equation to predict peak VO2, based on age.
Results: Peak VO2 decreased 0.9 mL/min/kg per age-decade, maximum HR also decreased with aging and VE/VCO2 slope was similar among all decades. The predicted new b-blocker equation to peak VO2 bb was 20.934 – 0.092 × age.
Conclusions: Clinical interpretation of aerobic capacity impairment is infl uenced by agingin HF patients. This evidence must be considered when using peak VO2 for prognostic stratification and clinical decision-making in patients with HF under b-blocker therapy.
Abstract
Background: Heart failure (HF) is associated with impaired maximal aerobic capacity asindicated by decreases in peak oxygen uptake (peak VO2). Considering that aging by itself has a negative effect on this variable, the evaluation of maximum capacity is often questioned because current predicted peak VO2 is based on subjects without heart disease or b-blocker therapy. In contrast, if decline in predicted and attained peak VO2 were age-related, proportionally, loss ofaerobic function (predicted peak VO2, %) would remain stable over time in these patients. The purpose of this investigation is to assess the effects of age on peak VO2 in HF patients taking b-blockers.\
Methods: We retrospectively evaluated 483 (132 female) patients (aged 20–88 years, LVEF31 ± 11%) with non-ischemic (n = 362), ischemic (n = 74) and Chagas-related HF (n = 47) who had been submitted to an incremental cardiopulmonary exercise testing on a motorized treadmill. Linear regression was used to develop the equation to predict peak VO2, based on age.
Results: Peak VO2 decreased 0.9 mL/min/kg per age-decade, maximum HR also decreased with aging and VE/VCO2 slope was similar among all decades. The predicted new b-blocker equation to peak VO2 bb was 20.934 – 0.092 × age.
Conclusions: Clinical interpretation of aerobic capacity impairment is infl uenced by agingin HF patients. This evidence must be considered when using peak VO2 for prognostic stratification and clinical decision-making in patients with HF under b-blocker therapy.
Keywords
aging, b-blocker therapy, cardiopulmonary exercise test, cardiorespiratory fitness, heart failure
About this articleTitle
Effects of age on aerobic capacity in heart failure patients under beta-blocker therapy: Possible impact in clinical decision-making?
Journal
Issue
Pages
655-661
Published online
2013-12-11
Page views
2196
Article views/downloads
2181
DOI
10.5603/CJ.2013.0166
Bibliographic record
Cardiol J 2013;20(6):655-661.
Keywords
aging
b-blocker therapy
cardiopulmonary exercise test
cardiorespiratory fitness
heart failure
Authors
Emmanuel Gomes Ciolac
Edimar Alcides Bocchi
Miguel Morita Fernandes da Silva
Aline Cristina Tavares
Iram Soares Teixeira-Neto
Guilherme Veiga Guimarães
