AIMS Exercise oscillatory ventilation (EOV) is a pivotal cardiopulmonary exercise test parameter for the prognostic evaluation of patients with chronic heart failure (HF). It has been described in patients with HF with reduced ejection fraction (<40%, HFrEF) and with HF with preserved ejection fraction (>50%, HFpEF), but no data are available for patients with HF with mid-range ejection fraction (40-49%, HFmrEF). The aim of the study was to evaluate the prognostic role of EOV in HFmrEF patients. METHODS AND RESULTS We analysed 1239 patients with HFmrEF and 4482 patients with HFrEF, enrolled in the MECKI score database, with a 2-year follow-up. The study endpoint was the composite of cardiovascular death, urgent heart transplant, and ventricular assist device implantation. We identified EOV in 968 cases (16% and 17% of cases in HFmrEF and HFrEF, respectively). HFrEF EOV+ patients were significantly older, and their parameters suggested a more severe HF than HFrEF EOV- patients. A similar behaviour was found in HFmrEF EOV+ vs. EOV- patients. Kaplan-Meier analysis, irrespective of ejection fraction, showed that EOV is associated with a worse survival, and that patients with HFrEF and HFmrEF EOV+ had a significantly worse outcome than the EOV- of the same ejection fraction groups. EOV-associated survival differences in HFmrEF patients started after 18 months of follow-up. CONCLUSION Exercise oscillatory ventilation has a similar prevalence and ominous prognostic value in both HFmrEF and HFrEF patients, indicating a group of patients in need of a more intensive follow-up and a more aggressive therapy. In HFmrEF, the survival curves between EOV+ and EOV- patients diverged only after 18 months.

中文翻译：

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中频射血分数降低的心力衰竭患者应进行振荡通气和预后。

AIMS运动振荡通气（EOV）是一项重要的心肺运动测试参数，用于评估慢性心力衰竭（HF）患者的预后。已针对射血分数降低的HF患者（<40％，HFrEF）和射血分数保留的HF患者（> 50％，HFpEF）进行了描述，但尚无有关中射血分数的HF患者的数据（ 40-49％，HFmrEF）。该研究的目的是评估EOV在HFmrEF患者中的预后作用。方法和结果我们分析了纳入MECKI评分数据库的1239例HFmrEF患者和4482例HFrEF患者，并进行了2年的随访。研究终点是心血管死亡，紧急心脏移植和心室辅助装置植入的综合。我们在968例病例中发现了EOV（HFmrEF和HFrEF分别为16％和17％）。HFrEF EOV +患者年龄较大，其参数提示HF比HFrEF EOV-患者严重。在HFmrEF EOV +与EOV-患者中发现了类似的行为。Kaplan-Meier分析与射血分数无关，表明EOV与较差的生存率相关，并且HFrEF和HFmrEF EOV +的患者比相同射血分数组的EOV-的结局显着更差。HFmrEF患者的EOV相关生存差异在随访18个月后开始。结论运动性振荡通气在HFmrEF和HFrEF患者中具有相似的患病率和不祥的预后价值，表明一组患者需要更深入的随访和更积极的治疗。在HFmrEF中，