021| Volume 26, ISSUE 10, SUPPLEMENT , S10, October 2020

Exercise Oscillatory Ventilation is Independently Associated with Right Ventricular Systolic Dysfunction in Patients with Chronic Heart Failure


      Exercise Oscillatory Ventilation (EOV) is a crucial marker for disease severity and prognosis in chronic heart failure (HF) patients. Although the presence of EOV in chronic HF patients has been demonstrated the association with worse left ventricular (LV) function, the evidence regarding with right ventricular (RV) function is still lacking. This study aim was to determine the association of EOV and RV systolic function in chronic heart failure patients.


      We retrospectively analyzed a cardiopulmonary exercise stress testing (CPET) database in 709 chronic HF patients at Cleveland Clinic, between April 2018 and June 2019. RV systolic dysfunction was determined by tricuspid annular plane systolic excursion (TAPSE) < 1.6 cm. or pulse doppler velocity at lateral tricuspid annulus (s’) < 10 cm/sec assessed by two dimension transthoracic echocardiography or RV ejection fraction (RVEF) < 53% assessed by cardiac magnetic resonance imaging (CMR). Definite EOV was used in the analysis. The prevalence of EOV was compared between the patients with and without RV systolic dysfunction. Multivariable logistic regression analysis was used for determine the association of EOV and RV systolic dysfunction.


      The prevalence of EOV in chronic HF patients with RV systolic dysfunction was significantly higher than those without RV systolic dysfunction (75.7% vs. 24.3%, p < 0.001). Multivariable logistic regression analysis revealed that EOV was independently associated with RV systolic dysfunction after adjusting for sex, history of diabetes mellitus (DM), chronic kidney disease (CKD), atrial fibrillation (AF), ventricular tachycardia (VT), LV ejection fraction (LVEF), presence of pulmonary hypertension (PH), tricuspid regurgitation (TR), and pulmonic regurgitation (PR), peak systolic and diastolic blood pressure, peak heart rate (HR), peak tidal volume (VT), peak oxygen consumption (peak VO2) and the minute ventilation/ carbon dioxide production relationship (VE/VCO2 slope) as shown in the table (odd ratio = 4.86, p < 0.001).


      In the large contemporary cohort, exercise oscillatory ventilation was independently associated with RV systolic dysfunction in chronic heart failure patients.
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