The ventilatory efficiency parameters outperform peak oxygen consumption in monitoring the therapy effects in patients with hypertrophic cardiomyopathy

SILICOFCM study investigators

doi:10.1016/j.pcad.2024.10.005

The ventilatory efficiency parameters outperform peak oxygen consumption in monitoring the therapy effects in patients with hypertrophic cardiomyopathy

SILICOFCM study investigators

Clinical and Hospital Center Zvezdara
University of Novi Sad
Newcastle University
University Medical Centre of Regensburg
Careggi University Hospital
University of Kragujevac
University of Illinois
Newcastle upon Tyne NHS Hospitals Foundation Trust
Mayo Clinic
University Clinical Center of Serbia
Institute of cardiovascular diseases of Vojvodina
University of Florence
University of Belgrade

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

Aim: We sought the cardiopulmonary exercise testing (CPET) parameter that most accurately reflected therapeutic efficacy in patients with hypertrophic cardiomyopathy (HCM). Methods: Well-being questionnaire, N-terminal brain natriuretic peptide measurements, echocardiography, and CPET were performed in patients with symptomatic non-obstructive HCM during phase II, randomized, open-label multicentre study, before and after 16 weeks of traditional or sacubitril/valsartan treatment. Patients were followed 36 months after the initial CPET. Primary endpoints were changes in: 1) peak oxygen consumption (VO ₂); 2) VO ₂ at anaerobic threshold (AT); 3) oxygen pulse; 4) minute ventilation (VE)/carbon-dioxide (CO ₂) production slope; 5) VE/VCO ₂ at AT (VE/VCO ₂_AT); 6) VE/VCO ₂ nadir; 7) VE/VCO ₂ intercept; and 8) partial end-tidal pressure of carbon-dioxide (P _ETCO ₂) change during CPET. Results: Of 115 screened patients, 61 (52 ± 14 years, 43 % women) were included. Within subject therapy effects were detected only by the VE/VCO ₂ intercept and P _ETCO ₂ change, whereas the differences between medical regimens were detected by differences in VE/VCO ₂ nadir and VE/VCO ₂_AT changes after the treatment. The best predictors of the change in well-being were left ventricular outflow tract maximal gradient and VE/VCO ₂ intercept (B = 0.41,0.36; SE = 0.16,0.30; CI = 0.14–0.79, 0.15–1.14; p = 0.006,0.016, respectively). Adverse cardiac events were best predicted by the initial VE/VCO ₂ nadir. Conclusion: Ventilatory efficiency parameters outperform peak VO ₂ in gauging therapy effects in patients with HCM.

Original language	English
Pages (from-to)	90-96
Number of pages	7
Journal	Progress in Cardiovascular Diseases
Volume	87
Early online date	16 Oct 2024
DOIs	https://doi.org/10.1016/j.pcad.2024.10.005
Publication status	Published - 1 Nov 2024

Funding

The authors have no conflicts of interest or financial ties to disclose. This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 777204. The design of the study, data collection, analyses, interpretation of data, and drafting of the manuscript do not reflect the views and opinions of the funders.

Funders	Funder number
Horizon Europe
???publication-publication-funding-organisation-not-added???	777204

Keywords

Cardiopulmonary exercise testing
Ventilatory efficiency
VE/VCO(2) intercept
VE/VCO(2) nadir
Hypertrophic cardiomyopathy
Therjavascript:void(0);apy effects

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10.1016/j.pcad.2024.10.005

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@article{457840b466e44bdb8c484b1323cd2c79,

title = "The ventilatory efficiency parameters outperform peak oxygen consumption in monitoring the therapy effects in patients with hypertrophic cardiomyopathy",

abstract = "Aim: We sought the cardiopulmonary exercise testing (CPET) parameter that most accurately reflected therapeutic efficacy in patients with hypertrophic cardiomyopathy (HCM). Methods: Well-being questionnaire, N-terminal brain natriuretic peptide measurements, echocardiography, and CPET were performed in patients with symptomatic non-obstructive HCM during phase II, randomized, open-label multicentre study, before and after 16 weeks of traditional or sacubitril/valsartan treatment. Patients were followed 36 months after the initial CPET. Primary endpoints were changes in: 1) peak oxygen consumption (VO 2); 2) VO 2 at anaerobic threshold (AT); 3) oxygen pulse; 4) minute ventilation (VE)/carbon-dioxide (CO 2) production slope; 5) VE/VCO 2 at AT (VE/VCO 2\_AT); 6) VE/VCO 2 nadir; 7) VE/VCO 2 intercept; and 8) partial end-tidal pressure of carbon-dioxide (P ETCO 2) change during CPET. Results: Of 115 screened patients, 61 (52 ± 14 years, 43 \% women) were included. Within subject therapy effects were detected only by the VE/VCO 2 intercept and P ETCO 2 change, whereas the differences between medical regimens were detected by differences in VE/VCO 2 nadir and VE/VCO 2\_AT changes after the treatment. The best predictors of the change in well-being were left ventricular outflow tract maximal gradient and VE/VCO 2 intercept (B = 0.41,0.36; SE = 0.16,0.30; CI = 0.14–0.79, 0.15–1.14; p = 0.006,0.016, respectively). Adverse cardiac events were best predicted by the initial VE/VCO 2 nadir. Conclusion: Ventilatory efficiency parameters outperform peak VO 2 in gauging therapy effects in patients with HCM.",

keywords = "Cardiopulmonary exercise testing, Ventilatory efficiency, VE/VCO(2) intercept, VE/VCO(2) nadir, Hypertrophic cardiomyopathy, Therjavascript:void(0);apy effects",

author = "\{SILICOFCM study investigators\} and Stefan Seman and Milorad Tesic and Marija Babic and Lidija Mikic and Lazar Velicki and Okwose, \{Nduka C\} and Charman, \{Sarah J\} and Maria Tafelmeier and Iacopo Olivotto and Nenad Filipovic and Arsen Ristic and Ross Arena and Marco Guazzi and Djordje Jakovljevic and Allison, \{Thomas G\} and Dejana Popovic",

year = "2024",

month = nov,

day = "1",

doi = "10.1016/j.pcad.2024.10.005",

language = "English",

volume = "87",

pages = "90--96",

journal = "Progress in Cardiovascular Diseases",

issn = "0033-0620",

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TY - JOUR

T1 - The ventilatory efficiency parameters outperform peak oxygen consumption in monitoring the therapy effects in patients with hypertrophic cardiomyopathy

AU - SILICOFCM study investigators

AU - Seman, Stefan

AU - Tesic, Milorad

AU - Babic, Marija

AU - Mikic, Lidija

AU - Velicki, Lazar

AU - Okwose, Nduka C

AU - Charman, Sarah J

AU - Tafelmeier, Maria

AU - Olivotto, Iacopo

AU - Filipovic, Nenad

AU - Ristic, Arsen

AU - Arena, Ross

AU - Guazzi, Marco

AU - Jakovljevic, Djordje

AU - Allison, Thomas G

AU - Popovic, Dejana

PY - 2024/11/1

Y1 - 2024/11/1

N2 - Aim: We sought the cardiopulmonary exercise testing (CPET) parameter that most accurately reflected therapeutic efficacy in patients with hypertrophic cardiomyopathy (HCM). Methods: Well-being questionnaire, N-terminal brain natriuretic peptide measurements, echocardiography, and CPET were performed in patients with symptomatic non-obstructive HCM during phase II, randomized, open-label multicentre study, before and after 16 weeks of traditional or sacubitril/valsartan treatment. Patients were followed 36 months after the initial CPET. Primary endpoints were changes in: 1) peak oxygen consumption (VO 2); 2) VO 2 at anaerobic threshold (AT); 3) oxygen pulse; 4) minute ventilation (VE)/carbon-dioxide (CO 2) production slope; 5) VE/VCO 2 at AT (VE/VCO 2_AT); 6) VE/VCO 2 nadir; 7) VE/VCO 2 intercept; and 8) partial end-tidal pressure of carbon-dioxide (P ETCO 2) change during CPET. Results: Of 115 screened patients, 61 (52 ± 14 years, 43 % women) were included. Within subject therapy effects were detected only by the VE/VCO 2 intercept and P ETCO 2 change, whereas the differences between medical regimens were detected by differences in VE/VCO 2 nadir and VE/VCO 2_AT changes after the treatment. The best predictors of the change in well-being were left ventricular outflow tract maximal gradient and VE/VCO 2 intercept (B = 0.41,0.36; SE = 0.16,0.30; CI = 0.14–0.79, 0.15–1.14; p = 0.006,0.016, respectively). Adverse cardiac events were best predicted by the initial VE/VCO 2 nadir. Conclusion: Ventilatory efficiency parameters outperform peak VO 2 in gauging therapy effects in patients with HCM.

AB - Aim: We sought the cardiopulmonary exercise testing (CPET) parameter that most accurately reflected therapeutic efficacy in patients with hypertrophic cardiomyopathy (HCM). Methods: Well-being questionnaire, N-terminal brain natriuretic peptide measurements, echocardiography, and CPET were performed in patients with symptomatic non-obstructive HCM during phase II, randomized, open-label multicentre study, before and after 16 weeks of traditional or sacubitril/valsartan treatment. Patients were followed 36 months after the initial CPET. Primary endpoints were changes in: 1) peak oxygen consumption (VO 2); 2) VO 2 at anaerobic threshold (AT); 3) oxygen pulse; 4) minute ventilation (VE)/carbon-dioxide (CO 2) production slope; 5) VE/VCO 2 at AT (VE/VCO 2_AT); 6) VE/VCO 2 nadir; 7) VE/VCO 2 intercept; and 8) partial end-tidal pressure of carbon-dioxide (P ETCO 2) change during CPET. Results: Of 115 screened patients, 61 (52 ± 14 years, 43 % women) were included. Within subject therapy effects were detected only by the VE/VCO 2 intercept and P ETCO 2 change, whereas the differences between medical regimens were detected by differences in VE/VCO 2 nadir and VE/VCO 2_AT changes after the treatment. The best predictors of the change in well-being were left ventricular outflow tract maximal gradient and VE/VCO 2 intercept (B = 0.41,0.36; SE = 0.16,0.30; CI = 0.14–0.79, 0.15–1.14; p = 0.006,0.016, respectively). Adverse cardiac events were best predicted by the initial VE/VCO 2 nadir. Conclusion: Ventilatory efficiency parameters outperform peak VO 2 in gauging therapy effects in patients with HCM.

KW - Cardiopulmonary exercise testing

KW - Ventilatory efficiency

KW - VE/VCO(2) intercept

KW - VE/VCO(2) nadir

KW - Hypertrophic cardiomyopathy

KW - Therjavascript:void(0);apy effects

UR - https://www.scopus.com/pages/publications/85207141187

U2 - 10.1016/j.pcad.2024.10.005

DO - 10.1016/j.pcad.2024.10.005

M3 - Article

C2 - 39424165

SN - 0033-0620

VL - 87

SP - 90

EP - 96

JO - Progress in Cardiovascular Diseases

JF - Progress in Cardiovascular Diseases

ER -

The ventilatory efficiency parameters outperform peak oxygen consumption in monitoring the therapy effects in patients with hypertrophic cardiomyopathy

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Keywords

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