Prognostic value of cardiopulmonary exercise test after heart transplantation

Background The clinical utility of cardiopulmonary exercise testing (CPET) has not been extensively studied yet in heart transplantation (HTX) patients. Objective To analyze the predictive value of the CPET on hospitalizations and mortality in HTX recipients. Methods A retrospective cohort was performed from a secondary database. Patients > 18 years with HTX who underwent a CPET between 3 and 12 months after transplantation were included. Time to the first primary endpoint (HTX-related hospitalization) was analyzed and adjusted using Cox proportional hazards regression model. Results A total of 122 patients (mean age 50.1 years, 77.0% men) were included. Fifty-seven patients (46.7%) had the primary endpoint. Peak VO2 (HR .95; CI 95% .90-.99, P = .03), oxygen pulse (HR .57; CI 95% .34-.96, P = .03) and predicted VO2 (HR .97; CI 95% .96-.99, P = .002) were associated with the endpoint. We did not find a significant association between the other variables and the outcome. Conclusion In HTX recipients, peak VO2, oxygen pulse, and predicted VO2 were independently associated with hospitalizations at follow up.

Automated summary

Cardiopulmonary exercise testing can predict the risk of hospitalizations and mortality in heart transplant recipients, with peak VO2, oxygen pulse, and predicted VO2 independently associated with hospitalization risk at follow up.