Effects of age on aerobic capacity in heart failure patients under beta-blocker therapy: possible impact in clinical decision-making?

Cardiol J. 2013;20(6):655-61. doi: 10.5603/CJ.2013.0166.

Abstract

Background: Heart failure (HF) is associated with impaired maximal aerobic capacity as indicated by decreases in peak oxygen uptake (peak VO(2)). Considering that aging by itself has a negative effect on this variable, the evaluation of maximum capacity is often questioned because current predicted peak VO(2) is based on subjects without heart disease or b-blocker therapy. In contrast, if decline in predicted and attained peak VO(2) were age-related, proportionally, loss of aerobic function (predicted peak VO(2), %) would remain stable over time in these patients. The purpose of this investigation is to assess the effects of age on peak VO(2) in HF patients taking b-blockers.

Methods: We retrospectively evaluated 483 (132 female) patients (aged 20-88 years, LVEF 31 ± 11%) with non-ischemic (n = 362), ischemic (n = 74) and Chagas-related HF (n = 47) who had been submitted to an incremental cardiopulmonary exercise testing on a motorized treadmill. Linear regression was used to develop the equation to predict peak VO(2), based on age.

Results: Peak VO(2) decreased 0.9 mL/min/kg per age-decade, maximum HR also decreased with aging and VE/VCO(2) slope was similar among all decades. The predicted new b-blocker equation to peak VO(2 bb) was 20.934 - 0.092 × age.

Conclusions: Clinical interpretation of aerobic capacity impairment is influenced by aging in HF patients. This evidence must be considered when using peak VO(2) for prognostic stratification and clinical decision-making in patients with HF under b-blocker therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Decision Support Techniques*
  • Exercise Test
  • Exercise Tolerance / drug effects*
  • Female
  • Heart Failure / diagnosis
  • Heart Failure / drug therapy*
  • Heart Failure / physiopathology
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Oxygen Consumption / drug effects*
  • Predictive Value of Tests
  • Retrospective Studies
  • Risk Factors
  • Stroke Volume / drug effects
  • Treatment Outcome
  • Ventricular Function, Left / drug effects
  • Young Adult

Substances

  • Adrenergic beta-Antagonists