Raw data of the paper "Cardiopulmonary Exercise Test Criteria for Heart Transplantation Referral of Ambulatory Heart Failure Patients in the Current Era" and of the paper "MECKI score thresholds for heart transplantation referral of ambulatory heart failure patients"

BackgroundCurrent guidelines recommend evaluating ambulatory heart failure (HF) patients for heart transplantation if their peak oxygen consumption (peak VO₂) is <12 ml/kg/min. However, these recommendations are based on decades-old data. MethodsWe retrospectively analyzed 8,060 ambulatory HF patients with cardiopulmonary exercise testing (CPET) data. The primary analysis focused on 1,218 patients with left ventricular ejection fraction <40% and peak VO₂ <12 ml/kg/min, enrolled between 2010 and 2022. Survival outcomes (composite of death/LVAD/ heart transplantation) were compared to those of heart transplantation recipients from the International Society for Heart and Lung Transplantation registry. Patients were stratified by ventilatory efficiency (VE/VCO₂ >34 vs. ≤34) and presence of exercise oscillatory ventilation. Survival analyses were performed using Kaplan–Meier curves compared with log-rank tests and Cox proportional hazards models, with heart transplantation survival curves reconstructed from aggregate data,. ResultsPatients with peak VO₂ <12 ml/kg/min demonstrated better survival than heart transplantation recipients, with survival curves intersecting at approximately 2.7 years. Among those with VE/VCO₂ ≤34, 10-year mortality risk was halved (p<0.01), with survival curves crossing those of heart transplantation recipients around year 4. Absence of exercise oscillatory ventilation was similarly associated with a 50% lower in long-term mortality. Combining VE/VCO₂ and exercise oscillatory ventilation identified four distinct risk groups with significantly different 10-year outcomes (p<0.01). Patients with peak VO₂ <12 ml/kg/min, VE/VCO₂ ≤34, and no exercise oscillatory ventilation exhibited survival comp arable to heart transplantation recipients at year 5.