{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T11:51:47Z","timestamp":1790596307841,"version":"4.1.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2019,1,11]],"date-time":"2019-01-11T00:00:00Z","timestamp":1547164800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2019,1,11]],"date-time":"2019-01-11T00:00:00Z","timestamp":1547164800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Exercise-derived parameters, specifically peak exercise oxygen uptake (peak VO2) and minute ventilation\/carbon dioxide relationship slope (VE\/VCO2 slope), have a pivotal prognostic value in heart failure (HF). It is unknown how the prognostic threshold of peak VO2 and VE\/VCO2 slope has changed over the last 20\u2009years in parallel with HF prognosis improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Data from 6083 HF patients (81% male, age 61\u2009\u00b1\u200913\u2009years), enrolled in the MECKI score database between 1993 and 2015, were retrospectively analysed. By enrolment year, four groups were generated: group 1 1993\u20132000 (n\u2009=\u2009440), group 2 2001\u20132005 (n\u2009=\u20091288), group 3 2006\u20132010 (n\u2009=\u20092368), and group 4 2011\u20132015 (n\u2009=\u20091987). We compared the 10-year survival of groups and analysed how the overall risk (cardiovascular death, urgent heart transplantation, or left ventricular assist device implantation) changed over time according to peak VO2 and VE\/VCO2 slope and to major clinical and therapeutic variables. At 10\u2009years, a progressively higher survival from group 1 to group 3 was observed, with no further improvement afterwards. A 20% risk for peak VO2 15\u2009mL\/min\/kg (95% confidence interval 16\u201313), 9 (11\u20138), 4 (4\u20132) and 5 (7\u20134) was observed in group 1, 2, 3, and 4, respectively, while the VE\/VCO2 slope value for a 20% risk was 32 (37\u201329), 47 (51\u201343), 59 (64\u201355), and 57 (63\u201352), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Heart failure prognosis improved over time up to 2010 in a HF population followed by experienced centres. The peak VO2 and VE\/VCO2 slope cut-offs identifying a definite risk progressively decreased and increased over time, respectively. The prognostic threshold of peak VO2 and VE\/VCO2 slope must be updated whenever HF prognosis improves.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.1364","type":"journal-article","created":{"date-parts":[[2019,1,11]],"date-time":"2019-01-11T05:34:37Z","timestamp":1547184877000},"page":"208-217","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":78,"title":["Heart Failure Prognosis Over Time: How the Prognostic Role of Oxygen Consumption and Ventilatory Efficiency During Exercise has Changed in the Last 20 Years"],"prefix":"10.1093","volume":"21","author":[{"given":"Stefania","family":"Paolillo","sequence":"first","affiliation":[{"name":"Department of Advanced Biomedical Sciences, Federico II University of Naples , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Veglia","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Salvioni","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ugo","family":"Corr\u00e0","sequence":"additional","affiliation":[{"name":"Division of Cardiac Rehabilitation, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Veruno , Veruno ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Piepoli","sequence":"additional","affiliation":[{"name":"Division of Cardiology, G. da Saliceto Hospital , Piacenza ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco","family":"Lagioia","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Cassano Murge , Bari ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Limongelli","sequence":"additional","affiliation":[{"name":"Cardiology SUN, Monaldi Hospital (Azienda dei Colli), Second University of Naples , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranco","family":"Sinagra","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Ospedali Riuniti and University of Trieste , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaia","family":"Cattadori","sequence":"additional","affiliation":[{"name":"Division of Cardiac Rehabilitation, Multimedica IRCCS , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela B.","family":"Scardovi","sequence":"additional","affiliation":[{"name":"Cardiology Division, Santo Spirito Hospital , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Metra","sequence":"additional","affiliation":[{"name":"Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Senni","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Failure and Heart Transplant Unit, Papa Giovanni XXIII Hospital , Bergamo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Bonomi","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Scrutinio","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific 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,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranco","family":"Parati","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Milano-Bicocca , Milan ,","place":["Italy"]},{"name":"Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Istituto Auxologico Italiano , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Re","sequence":"additional","affiliation":[{"name":"Cardiology Division, Cardiac Arrhythmia Center and Cardiomyopathies Unit, San Camillo-Forlanini Hospital , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariantonietta","family":"Cicoira","sequence":"additional","affiliation":[{"name":"Section of Cardiology, Department of Medicine, University of Verona , Verona ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Min\u00e0","sequence":"additional","affiliation":[{"name":"Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS \u2013 ISMETT , Palermo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Correale","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Foggia , Foggia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Frigerio","sequence":"additional","affiliation":[{"name":"\u2018A. De Gasperis\u2019 Cardiology Department, Niguarda Hospital , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Bussotti","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation Unit, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Milan , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Battaia","sequence":"additional","affiliation":[{"name":"Department of Cardiology, S. Chiara Hospital , Trento ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Guazzi","sequence":"additional","affiliation":[{"name":"Cardiology University Department, Heart Failure Unit and Cardiopulmonary Laboratory, IRCCS Policlinico San Donato , San Donato Milanese, Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Badagliacca","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Respiratory, Nephrological, Anesthesiological, and Geriatric Sciences, Sapienza University of Rome , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Di Lenarda","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Health Authority 1 and University of Trieste , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo","family":"Maggioni","sequence":"additional","affiliation":[{"name":"ANMCO Research Center , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Passino","sequence":"additional","affiliation":[{"name":"Gabriele Monasterio Foundation, CNR-Regione Toscana , Pisa ,","place":["Italy"]},{"name":"Life Science Institute, Scuola Superiore Sant'Anna , Pisa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Sciomer","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Respiratory, Nephrological, Anesthesiological, and Geriatric Sciences, Sapienza University of Rome , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Pacileo","sequence":"additional","affiliation":[{"name":"Cardiology SUN, Monaldi Hospital (Azienda dei Colli), Second University of Naples , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Mapelli","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Vignati","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Clemenza","sequence":"additional","affiliation":[{"name":"Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS \u2013 ISMETT , Palermo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Binno","sequence":"additional","affiliation":[{"name":"Division of Cardiology, G. da Saliceto Hospital , Piacenza ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale Perrone","family":"Filardi","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, Federico II University of Naples , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piergiuseppe","family":"Agostoni","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS , Milan ,","place":["Italy"]},{"name":"Cardiovascular Section, Department of Clinical Sciences and Community Health, University of Milan , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,1,11]]},"reference":[{"key":"2026011721292516800_ejhf1364-bib-0001","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1161\/CIRCRESAHA.113.300268","article-title":"Epidemiology of heart failure","volume":"113","author":"Roger","year":"2013","journal-title":"Circ Res"},{"key":"2026011721292516800_ejhf1364-bib-0002","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1002\/ejhf.592","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). 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