Heart failure & cardiomyopathiesCohort study

Age-Stratified Prognostic Value of Cardiopulmonary Exercise Testing Parameters in Patients With Heart Failure

JACC AdvPublished

  • retrospective multicenter cohort study

Authors' conclusion

Although CPET parameters were associated with adverse outcomes across age groups, the prognostic contribution of peak VO2 was most pronounced in older patients with HF, highlighting the importance of CPET-based risk stratification in this population.

Study context

Population
Patients with heart failure (HF) who underwent cardiopulmonary exercise testing (CPET), examined in 3 age groupspatients with HF who underwent CPET
Participants
830 patients
Exposure
age-stratified prognostic value of CPET parameters for adverse outcomes in patients with HF
Outcome
composite of:
  • All-cause death
  • HF hospitalization
Follow-up
Within 3 years

Main finding

As reported in the abstract

patients experienced adverse outcomes

176/830

Observational data: associations, not effects.

Further findings

Outcome20 to 6465 to 79≥80 years
Peak VO2 and adverse outcomesNot reported in the abstractNot reported in the abstractHR 0.72 (95% CI 0.62–0.85)
Area under the curve of peak VO2 · tended to increase with ageNot reported in the abstractNot reported in the abstractAUC 0.81 (95% CI 0.70–0.91)
Area under the curve of VE/VCO2 slope · comparable across age groupsNot reported in the abstractNot reported in the abstractAUC 0.68 (95% CI 0.55–0.81)
  • Peak VO2 and adverse outcomes: 65-79 years HR 0.90 (95% CI 0.84–0.96)
  • Peak VO2 and adverse outcomes: associated with adverse outcomes in patients 65 years or older
  • Area under the curve of peak VO2: 20-64 years AUC 0.61 (95% CI 0.53–0.69)
  • Area under the curve of peak VO2: 65-79 years AUC 0.74 (95% CI 0.67–0.81)
  • Area under the curve of VE/VCO2 slope: 20-64 years AUC 0.64 (95% CI 0.56–0.72)
  • Area under the curve of VE/VCO2 slope: 65-79 years AUC 0.68 (95% CI 0.60–0.76)

VE/VCO2 slope and adverse outcomes

consistently associated across age groups
P < 0.05 for all

Original publication

Age-Stratified Prognostic Value of Cardiopulmonary Exercise Testing Parameters in Patients With Heart Failure. JACC Adv. Published 15 July 2026. doi:10.1016/j.jacadv.2026.103008

Summarised from the published abstract; every number is checked against it