Exercise oscillatory ventilation (EOV) as a predictor of mortality in patients with amyloid cardiomyopathy

<bold>Background:</bold> Exercise oscillatory ventilation (EOV) signals multiple abnormalities in hemodynamics and ventilatory control which may predict poor outcome in patients with cardiac diseases. <bold>Aim:</bold> To assess whether EOV (+) patients with amyloid cardiomyopathy show higher mortality rates compared to their counterparts without EOV. <bold>Methods:</bold> We analyzed cardiopulmonary exercise testing for EOV, defined by continuous (>60% of exercise duration) oscillations in minute ventilation (VE), cycling with a frequency of one minute and an amplitude above 15% of resting VE. <bold>Results:</bold> 156 patients with amyloid cardiomyopathy, aged 78 (±7) years, 87% male with a NYHA functional class of II (49.4%) and median B-type natriuretic peptide levels of 2548 (1374-4703) ng/L, had a mean peak oxygen consumption of 14.8 (±4.42) ml/kg·min and a VE to carbon dioxide production (VCO2) slope ≥ 40 in 67.9% of cases. EOV was seen in 38 (24.4%), clearly absent in 92 (59.0%) and not clearly differentiable in 26 (16.7%) patients. 33 (21.2%) had a HF-related hospitalization and 31 (19.9%) died. EOV shows a hazard ratio of 2.35 (CI 1.088 – 5.075, p-value <0.05) for all-cause mortality. In fact, the log-rank test showed a difference in survival time between patients with and without EOV (p=0.03) with a median survival time of 46 months. <bold>Conclusion:</bold> EOV may improve the prognostic yield of incremental CPET in patients with amyloid cardiomyopathy. <fig><object-id>erj;64/suppl_68/OA1958/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>