VO2T12.5% (the time for VO2 to decline by 12.5% from peak) is established as a cardiospecific metric, correlating with exercise hemodynamics (PCWP/CO slope) rather than peripheral factors.
Prolonged VO2T12.5% is a robust independent predictor of heart failure hospitalization and mortality, with a hazard ratio of 1.54 per 15-second increase.
Treatment with the cardiac myosin inhibitor aficamten significantly accelerates VO2 recovery, with a mean improvement of 8 seconds compared to placebo.
Improvements in recovery speed correlate directly with physiological markers of reduced obstruction, including lower LVOT gradients and decreased cardiac biomarkers.
