Ultrafiltration in moderate XXXX . Exercise @entity26 uptake as a predictor of the clinical benefits.

@entity1 @entity712 @entity26 @entity1063 @entity2798
OBJECTIVE: Ultrafiltration (UF) can improve the exercise performance of @entity1 with moderate @entity712 ( @entity712 ). Our aim was to define the starting levels of performance below which UF is beneficial. @entity1 AND METHOD: We studied 26 @entity1 in 2 to 3 NYHA class, whose clinical condition was stable, left ventricle ejection fraction (echocardiography) was < 35% and peak exercise @entity26 uptake (VO2) was > or = 14 mL/min/kg. They underwent a single extracorporeal UF (about 600 mL of ultrafiltrate per hour). Before that, we evaluated pulmonary function (PFT), functional capacity (cardiopulmonary exercise test [CPX]), cardiac index, left ventricle ejection fraction, ventricular filling pressures, and plasma @entity1063 at rest. The PFTs and CPXs were repeated 3 months after UF. RESULTS: Sixteen @entity1 had a rise of peak exercise VO2 > 1 mL/min/kg at the 3-month evaluation (group A, ultrafiltrate = 2,040 +/- 241 mL) and 10 did not (group B, ultrafiltrate = 1,870 +/- 169 mL). Forced expiratory volume (1 s), maximal @entity2798 , and vital capacity were lower in group A than in group B and improved after UF only in group A. Before UF, VO2 at peak exercise and at anaerobic threshold (15.5 +/- 0.4 mL/min/kg and 11.0 +/- 0.5, respectively) was also lower in group A than in group B (21.2 +/- 0.7 mL/min/kg and 14.8 +/- 0.9, p < 0.01). @entity1 whose pre-UF peak exercise VO2 was > 18.5 mL/min/kg (group B) had no increase in this variable. No significant group differences were detected regarding @entity1063 , left ventricular ejection fraction, and hemodyanmic parameters at rest. CONCLUSION: In @entity1 with moderate @entity712 undergoing UF, exercise capacity improvement is inversely related to the pre-UF level of physical performance and pulmonary function; VO2 at peak exercise seems useful for identification of @entity1 not benefiting from the procedure.
