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Identification of prognostic variables from the cardiopulmonary exercise test to stratify Heart Failure severity

Grant number: 20/13465-5
Support Opportunities:Scholarships abroad - Research Internship - Doctorate (Direct)
Start date: November 30, 2021
End date: March 29, 2022
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:Audrey Borghi Silva
Grantee:Cássia da Luz Goulart
Supervisor: Agostoni Piergiuseppe
Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil
Institution abroad: Università degli Studi di Milano, Italy  
Associated to the scholarship:18/03233-0 - Study of cardiorespiratory interaction and the supply of peripheral and cerebral oxygen as modulators of exercise capacity during bilevel application in the coexistence of COPD-CHF, BP.DD

Abstract

Heart Failure (HF) patients have shown mark intolerance towards exercise, which is related to the severity of the disease. Therefore, it is of utmost importance to perform tests of maximum exercise, since they can measure and identify possible cutoff points to stratify HF gravity. Aim: To analyze all the variables derived from the cardiopulmonary exercise testing (CPET), but prioritize Oxygen uptake (VO2)/ workload (WR), ventilation intercept (VEint), Circulatory Power (CP) and Ventilatory Power (VP); to evaluate the behavior of these variables in the different classifications of HF, and draw prognosis and mortality cut points in these patients, if proven feasible; secondarily, evaluate the impact of Chronic obstructive pulmonary disease coexistence on HF in these variables. Methods: This is a multicenter study, in which the patients already gathered in the sampling process in the thematic project will be analyzed and shared. Being this BEPE scholarship approved, a database will be gathered with the patients already gathered in the sampling process from Brazil and Italy, and also the patients to be evaluated during the stay in Italy.HF patients with an ejection fraction of <49% were and will be considered. All patients will perform CPET on an electronically braked cycle ergometer and respiratory gas analysis will be measured breath-by-breath. During CPET, the following parameters were and will be measured: VO2 (ml/kg/min), Ventilation (VE), VCO2 (ml/min), VE/VCO2 slope, WR (watts), Heart rate peak (bpm), SBP and DBP. New risk and prognosis indexes in the population that will be further analyzed: VEint, VO2/WR, CP and VP. (AU)

News published in Agência FAPESP Newsletter about the scholarship:
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Scientific publications (10)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
C.F. FAGUNDES; L. DI THOMMAZO-LUPORINI; C.L. GOULART; D. BRAATZ; A. DITOMASO; A. BORGHI-SILVA. Reference equations of oxygen uptake for the step test in the obese population. Brazilian Journal of Medical and Biological Research, v. 55, . (18/03233-0, 20/13465-5, 15/26501-1)
GOULART, GASSIA DA LUZ; AGOSTONI, PIERGIUSEPPE; SALVIONI, ELISABETTA; SILVA, REBECA NUNES; BASSI-DIBAI, DANIELA; ROSCANI, MELIZA GOI; ARENA, ROSS; MYERS, JONATHAN; BORGHI-SILVA, AUDREY. Phenotyping cardiopulmonary exercise testing measures in heart failure with reduced ejection fraction: A comparison between Italy and Brazil. HEART & LUNG, v. 65, p. 5-pg., . (20/13465-5, 18/03233-0)
GOULART, C. L.; OLIVEIRA, M. R.; RENATA, M. G.; SILVA, A. B.. Prognostic Value of Key Variables from Cardiopulmonary Exercise Testing in Patients with COPD: 42-Month Follow-Up. American Journal of Respiratory and Critical Care Medicine, v. 205, p. 1-pg., . (18/03233-0, 15/26501-1, 20/13465-5)
GOULART, CASSIA DA LUZ; AGOSTONI, PIERGIUSEPPE; SALVIONI, ELISABETTA; KAMINSKY, LEONARD A.; MYERS, JON; ARENA, ROSS; BORGHI-SILVA, AUDREY. Exercise oscillatory breathing in heart failure with reduced ejection fraction: clinical implication. EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, v. N/A, p. 7-pg., . (20/13465-5, 18/03233-0)
SIMOES, RODRIGO POLAQUINI; GOULART, CASSIA DA LUZ; CARUSO, FLAVIA ROSSI; ARAUJO, ADRIANA S. GARCIA DE; DE MOURA, SILVIA CRISTINA GARCIA; CATAI, APARECIDA MARIA; DOS SANTOS, POLLIANA BATISTA; CAMARGO, PATRICIA DE FARIA; MARINHO, RENAN SHIDA; MENDES, RENATA GONCALVES; et al. Non-invasive ventilatory support accelerates the oxygen uptake and heart rate kinetics and improves muscle oxygenation dynamics in COPD-HF patients. AMERICAN JOURNAL OF THE MEDICAL SCIENCES, v. 366, n. 2, p. 11-pg., . (18/03233-0, 20/13465-5)
GOULART, CASSIA DA LUZ; SILVA, REBECA NUNES; AGOSTONI, PIERGIUSEPPE; FRANSSEN, FRITS M. E.; MYERS, JONATHAN; ARENA, ROSS; BORGHI-SILVA, AUDREY. Exercise oscillatory ventilation in patients with coexisting chronic obstructive pulmonary disease and heart failure: Clinical implications. RESPIRATORY MEDICINE, v. 217, p. 5-pg., . (18/03233-0, 20/13465-5)
GOULART, CASSIA DA LUZ; OLIVEIRA, MURILO REZENDE; ALBURQUERQUE SENDIN, FRANCISCO; MENDES, RENATA GONCALVES; ARENA, ROSS; BORGHI-SILVA, AUDREY. Prognostic value of key variables from cardiopulmonary exercise testing in patients with COPD: 42-month follow-up. RESPIRATORY MEDICINE, v. 197, p. 6-pg., . (18/03233-0, 20/13465-5)
BACK, G.; DA LUZ GOULART, C.; OLIVEIRA, M.; CAMARGO, P. F.; OLIVEIRA, C.; WENDE, K.; BONJORNO JUNIOR, J.; ARBEX, R.; CARUSO, F.; ARENA, R.; et al. Does Mild to Moderate COVID-19 Infection Impair Lung Function and Exercise Capacity After One Month of Recovery?. American Journal of Respiratory and Critical Care Medicine, v. 205, p. 1-pg., . (18/03233-0, 20/13465-5)
FAGUNDES, C. F.; DI THOMMAZO-LUPORINI, L.; GOULART, C. L.; BRAATZ, D.; DITOMASO, A.; BORGHI-SILVA, A.. Reference equations of oxygen uptake for the step test in the obese population. Brazilian Journal of Medical and Biological Research, v. 55, n. 1, p. 8-pg., . (18/03233-0, 15/26501-1, 20/13465-5)
GOULART, CASSIA DA LUZ; CARUSO, FLAVIA ROSSI; DE ARAUJO, ADRIANA SANCHES GARCIA; MOURA, SILVIA CRISTINA GARCIA DE; CATAI, APARECIDA MARIA; AGOSTONI, PIERGIUSEPPE; MENDES, RENATA GONCALVES; ARENA, ROSS; BORGHI-SILVA, AUDREY. an Non-invasive Ventilation Modulate Cerebral, Respiratory, and Peripheral Muscle Oxygenation During High-Intensity Exercise in Patients With COPD-HF. FRONTIERS IN CARDIOVASCULAR MEDICINE, v. 8, . (20/13465-5, 18/03233-0)