背景：心衰竭存活分數、最大攝氧量、及呼吸效能用於預测心衰竭病患的存活率。然而大多研究以男性為主，對於女性是否有相同的預测力目前仍未知。方法：選取自2004至2011年間 '轉介做換心評估並完成 運動肺功能檢查的患者，共39名女性(20.0%) ，並選取了 77名（39.5%)年齡及最大攝氧量相符的男性病患,比較各指標在性別間的預測力,病患追蹤的終點定義為死亡、侵入性輔助器置入、或是換心。3個指標的分組 方式分別為：（1)呼吸效能低於中位敷列入低危險組，其餘列入高危險組；（2)心衰竭存活分數小於等於7.19 ' 介於7.20至8.09 .大於8.10分別為高、中、低危險；（3)最大攝氧量大於14 ml/kg/min •介於10到14 ml/kg/ min ’小於等於10 ml/kg/min分別為低、中、高危險。利用存活分析男女分開分別畫出3項指標各組的生存曲線，統計顯著訂於P值小於0.05。結果：以呼吸效能分組在不同性別的预測力有顯著不同(p = 0.043)，以最大攝氧 量及心衰竭存活分數分组男女間皆沒有顯著差異。結論：運動中呼吸效能的損傷對於女性心衰竭族群是較佳的 預測因子。（物理治療2016;41(4):271-279)

Background: Heart Failure Survival Score (HFSS), peak exercise oxygen consumption (V02), and ventilatory equivalent (ventiIation/C02 Producdon, VE/VCG2) slope have been suggested to predict survival in ambulatory patients with heart failure (HF) and are used for selection for heart transplancacion (HTx). However most study populations were predominantly male. It is unclear if the prognostic powers are similar between genders. Methods： From 2004 to 2011 there were thirty-nine (20,0%) female HF patients referred for pie-HTx evaluation with complete exercise pulmonary function test (EPFT), and the data were collected retrospectively. Seventy-seven (39.5%) male patients matched in age and peak VOz were selected to compare gender differences. Both peak V02 and VE/ VC02 slope were obtained from the results of EPFT. Seven HFSS parameters were obtained from chart review. Tlic outcomes were death, mechanical devices implancarion, or HTx. The VE/VC02 slope lower than the medium value was defined as low risk, and that greater than the medium value was defined as high risk. Subjects were divided into high-j medium-} and low-risk strata for HFSS based on previous cutoff points of 8.10 and 7.19 and V02 based on cutoff poinrs of 14 ml/kg/min. Survival curves were generated separately for each of the two VE/VC02 slope strata, three peak V02 strata, and three HFSS risk strata using the Kaplan-Meier (KM) method. To further identify gender difference survival curve was generated by adjusting gender. Results： The mean peak V02, VE/VC02 slope> and HFSS were 14.5 ± 4.9 ml/kg/min，38.2 ± 10.9 and 7.1 ±0.7, respecdvely. Considering gender difference，VE/ VC02 slope was a powerful predictor (p= 0.043). Survival curves for different srrata based on peak VQ2 and HFSS were not significantly different (p > 0.05) in both gender groups. Conclusion: Impairment in exercise ventilation holds clinical prognostic impact after adjusting gender factor in HF patients. (FJPT 20l6;4l (4)：271-279)