The value of cardiopulmonary exercise testing and stress echocardiography in the prediction of all‐cause mortality in adults with end‐stage renal disease
Journal article
O'Driscoll, J., Edwards, J.J., Greenhough, E., Smith, E., May, M., Gupta, S., Marciniak, A. and Sharma, R. 2023. The value of cardiopulmonary exercise testing and stress echocardiography in the prediction of all‐cause mortality in adults with end‐stage renal disease. European Journal of Sport Science. 23 (8), pp. 1800-1809. https://doi.org/10.1080/17461391.2023.2184727
| Authors | O'Driscoll, J., Edwards, J.J., Greenhough, E., Smith, E., May, M., Gupta, S., Marciniak, A. and Sharma, R. |
|---|---|
| Abstract | ABSTRACTWe aimed to assess the prognostic utility of different parameters routinely assessed from cardiopulmonary exercise testing (CPET) and exercise echocardiography in adults with end‐stage renal disease (ESRD). Forty‐two ESRD (37 male) individuals (age: 58 ± 13 years, height: 169.30 ± 8.30 cm, weight: 81 ± 15 kg, body surface area: 1.92 ± 0.20 m2) underwent a maximal/symptom limited CPET, with a full cross‐sectional echocardiogram performed at baseline and peak exercise. All participants were prospectively followed over a 10‐year period, with all‐cause mortality as the primary endpoint. After the follow‐up period, a total of 19 participants (45%) died. Left atrial size (4.70 ± 0.70 vs. 3.65 ± 0.50 cm, P < 0.001) and anteroseptal wall thickness (1.28 ± 0.40 vs. 1.06 ± 0.02 cm, P = 0.002) were significantly greater in those that died, while peak heart rate was significantly lower (108 ± 12 vs. 128 ± 14 bpm, P < 0.001). The prevalence of myocardial ischaemia (13 vs. 8 participants, P = 0.03) was significantly greater, while peak VO2 (9.80 ± 2.10 vs. 15.90 ± 4.30 ml·kg−1·min−1, P < 0.001) was significantly lower in those that died. Following multivariate cox regression, myocardial ischaemia (Hazard Ratio 3.08; 95% Confidence Interval 1.09–8.70; P = 0.03) and peak VO2 (HR 0.73; 95% CI 0.64–0.84; P < 0.001) were significant independent predictors of 10‐year all‐cause mortality. This is the first study to establish peak VO2 as powerful marker of all‐cause mortality when assessed with clinical, resting and stress echocardiography parameters in people with ESRD over a 10‐year follow up period. This observation indicates that, in clinical practice, CPET and exercise echocardiography may serve as valuable tools for the risk stratification of individuals with ESRD. |
| Keywords | Orthopedics and Sports Medicine; Physical Therapy, Sports Therapy and Rehabilitation; General Medicine |
| Year | 2023 |
| Journal | European Journal of Sport Science |
| Journal citation | 23 (8), pp. 1800-1809 |
| Publisher | Wiley |
| ISSN | 1536-7290 |
| Digital Object Identifier (DOI) | https://doi.org/10.1080/17461391.2023.2184727 |
| Official URL | https://www.tandfonline.com/doi/full/10.1080/17461391.2023.2184727 |
| Publication dates | |
| 03 Aug 2023 | |
| Online | 15 Mar 2023 |
| Publication process dates | |
| Accepted | 13 Feb 2023 |
| Deposited | 06 Mar 2023 |
| Accepted author manuscript | |
| Output status | Published |
| Additional information | Publications router: Date 2023-03-15 of type 'publication_date' with format 'electronic' included in notification |
Publications router: License for VOR version of this article starting on 2023-03-15: http://onlinelibrary.wiley.com/termsAndConditions#vor included in notification | |
| Page range | 1-10 |
| License | http://onlinelibrary.wiley.com/termsAndConditions#vor |
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