Heart failure & cardiomyopathies
A novel method to classify exercise response in patients with cardiac amyloidosis—the RoMa classification
Authors' conclusion
In ATTR-CM, application of the RoMa classification was feasible and identified distinct CPET-derived exercise-response profiles associated with functional impairment.
Study context
- Population
- Adults with confirmed ATTR-CM who completed symptom-limited maximal cardiopulmonary exercise testing (CPET)90% male
- Participants
- 165 adults
- Exposure
- RoMa classes I–IV
- RoMa In = 33reference
- RoMa IIn = 73
- RoMa IIIn = 30
- RoMa IVn = 29
- Outcome
- Association of RoMa class with functional capacity and key CPET parameters
Methodological detailstwo tertiary centres, consecutive patients
- Two tertiary centres
- Consecutive patients
Main finding
As reported in the abstract
Functional capacity and CPET parameters across RoMa classes
| Group | Median 6MWD | Peak VO2 (% predicted) | VE/VCO2 slope | Peak PetCO2 |
|---|---|---|---|---|
| RoMa I | 420 m | 93.0 | 34 | 30 |
| RoMa II | 70.8 | 39 | 27 | |
| RoMa III | 75.2 | 37 | 29 | |
| RoMa IV | 313 m | 51.9 | 47 | 25 |
Median 6MWD
RoMa I420 m
RoMa IINot reported in the abstract
RoMa IIINot reported in the abstract
RoMa IV313 m
Peak VO2 (% predicted)
RoMa I93.0
RoMa II70.8
RoMa III75.2
RoMa IV51.9
VE/VCO2 slope
RoMa I34
RoMa II39
RoMa III37
RoMa IV47
Peak PetCO2
RoMa I30
RoMa II27
RoMa III29
RoMa IV25
- 6MWD across classes
- overall p=0.009; p-trend=0.005
- NYHA class worsened across classes
- overall p=0.003; p-trend=0.005
- Peak VO2 (% predicted) across classes
- overall p<0.001; p-trend<0.001
- VE/VCO2 slope across classes
- overall p<0.001; p-trend<0.001
- Peak PetCO2 across classes
- overall p<0.001; p-trend=0.003
- Age did not differ across classes
- P = 0.36
Observational data: associations, not effects.
Further findings
Correlations of 6MWD with CPET parameters
- 6MWD vs peak VO2 (n=131)
- r=0.626; p<0.001
- 6MWD vs VE/VCO2 slope, inverse (n=130)
- ρ=−0.484; p<0.001
Original publication
A novel method to classify exercise response in patients with cardiac amyloidosis—the RoMa classification. Eur J Prev Cardiol. Published 23 July 2026. doi:10.
Summarised from the published abstract; every number is checked against it