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The Pathophysiological Implication of the Interaction Between Arteriovenous Oxygen Content Difference and Cardiac Output during Exercise on Heart Failure

      Background: The pathophysiological implication of the interaction between arteriovenous oxygen content difference (AVO2Diff) and cardiac output (CO) during exercise on heart failure is unclear. Objective: To investigate the pathophysiological implication of interaction between AVO2Diff and CO on heart failure. Methods: a retrospective cohort study. 95 patients who underwent cardiopulmonary exercise test and exercise echocardiography simultaneously for the assessment of cardiac function were classified into 5 groups by hierarchical clustering based on oxygen consumption (VO2), CO and AVO2Diff at submaximal exercise. Of 5 cluster, Cluster 1 (C1, n = 19) and Cluster 4 (C4, n = 19) have similar VO2 but opposite interaction CO with AVO2Diff. Prevalence of heart failure in each cluster was investigated. Results: VO2 (mL⋅min−1⋅kg−1) was similar between groups (11.1 ± 1.1 vs 11.5 ± 0.7). C1 had lower CO (L/min) and higher AVO2Diff than C4 (5.28 ± 0.86 vs 8.67 ± 1.67; P < .0001, 13.0 ± 1.8 vs 8.8 ± 0.2; P < .0001, respectively). The prevalence of heart failure was higher in C1 than in C4 (68.4% vs 21.1%, P = .0134) and history of hospitalization due to congestive heart failure was more common in C1 (47.4% vs 10.0%, odds ratio [95% CI] = 8.50 [1.50 to 48.1], P = .0128). Conclusion: The assessment of interaction between AVO2Diff and CO may be useful in the risk stratification of heart failure.
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