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Men and women may need different heart transplant assessment criteria

(BETHESDA, MD) Peak oxygen consumption during an exercise test is one of the key criteria used to determine when a heart failure patient may need a heart transplant, but the standard values currently used may not accurately predict outcomes for female patients, according to a new study in the June 6, 2006, issue of the Journal of the American College of Cardiology.

"There is some fundamental difference between the genders and we have to be sensitive to that," said Andrew Kao, M.D., F.A.C.C. Dr. Kao was at the University of Pennsylvania School of Medicine in Philadelphia at the time of this study. He is now with Cardiovascular Consultants, PA, which manages the Mid-America Heart Institute in Kansas City, Missouri.

Peak oxygen consumption (VO2) is a powerful and reliable predictor of survival in patients with advanced heart failure. If a patient who is working hard on the treadmill is consuming less than about 12 milliliters of oxygen per kilogram of body weight per minute (ml/kg/min), then the odds of long-term survival may be poor and it is generally thought to be appropriate to consider heart transplantation, Dr. Kao said.

However, the VO2 standards are based on the experiences of patients who were almost all men.

"Most of us in tertiary referral centers end up seeing mostly men, and so the reports that come out are mostly on men. We took this opportunity to go back and look at all of our heart failure patients, both men and women." Dr. Kao said. The researchers, including first author Sammy Elmariah, M.D., from the University of Pennsylvania School of Medicine, reviewed the records of 594 heart failure patients who took treadmill exercise tests at the University of Pennsylvania's Heart Failure and Transplant Ambulatory Care Center between July 2000 and December 2003. They found that on average women had significantly lower peak VO2 compared to men, despite adjusting for their body size. However, women had better survival rates tha
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Contact: Amy Murphy
amurphy@acc.org
301-581-3476
American College of Cardiology
2-Jun-2006


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