Background: Exercise performance at CPET is a valuable tool to stratify prognosis in heart failure (HF) patients. Despite a strong rationale, less is known about the role of CPET in the general population with a variable profile of cardiovascular risk.
Aim: To assess whether a higher cardiovascular risk profile is associated with worse exercise performance at CPET.
Methods: 672 subjects enrolled in the EURO-EX trial, with different CV risk profile, underwent maximal CPET.We stratified patients according to the number of CVRFs (hypertension, diabetes, dyslipidemia, smoking, BMI>25). 263 subjects underwent echocardiography.
Results: CV risk factors were distributed as described in the table. 528 patients (78.5%) had BMI > 25; 510 (75.8%) had hypertension; 368 (54.7%) had dyslipidemia; 167 (24.8%) were smokers; 122 (18.1%) had diabetes.Results are shown in the table.
Discussion: A more severe CV risk profile is associated with worse CPET performance, even adjusting with age (percent of predicted VO2). Moreover, patients with higher rate of MCVRFs display a peculiar cardiac phenotype: increased left atrial dimensions, and increased relative wall thickness (despite no differences in LV mass), prospecting that an early increase in left atrium size might be sensitive and specific for worse performance.