Cardiopulmonary Exercise Testing Identifies Low Risk Patients With Heart Failure and Severely Impaired Exercise Capacity Considered for Heart Transplantation

Osada, Naohiko; Chaitman, Bernard R.; Miller, Leslie W.; Yip, Daniel; Cishek, Mary Beth; Wolford, Thomas; Donohue, Thomas J.

doi:10.1016/s0735-1097(97)00533-0

Cited by 148 publications

(81 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the previous studies with cardiopulmonary exercise tests, the blood pressure response to submaximal exercise was a significant predictor of prognosis in CHF. 14,15) Although there are several differences in patient selection and methodology, our findings are consistent with previous results 14,15) showing that an abnormally low SBP response during exercise is a significant predictor of prognosis with CHF.…”

Section: Discussionsupporting

confidence: 92%

Systolic Blood Pressure Response to Exercise as a Predictor of Mortality in Patients With Chronic Heart Failure

et al. 2010

View full text Add to dashboard Cite

SummaryIt is well known that peak oxygen consumption and heart rate (HR) recovery after exercise obtained from the cardiopulmonary exercise test are prognostic parameters in patients with chronic heart failure (CHF). However, it is unclear whether exercise-induced parameters obtained from the routine exercise stress test predict mortality in patients with CHF.We studied 136 patients (93 males/43 females) with CHF. All patients underwent symptom-limited exercise stress testing. Exercise parameters included exercise duration, exercise-induced HR and systolic blood pressure (SBP), and metabolic equivalents (METs).During the follow-up period (mean 6.2 years), 34 patients died. Survival rates at the 3rd and 5th years were 90% and 83%, respectively. Body mass index was significantly smaller in the nonsurvival group than in the survival group (P < 0.01). The incidence of patients with New York Heart Association III class was higher in the nonsurvival group than in the survival group (P < 0.05). In univariate analysis, predictors of mortality included peak HR and SBP, increases in HR and SBP during exercise, HR and SBP at the 1st minute after exercise, HR at the 3rd minute after exercise, and METs. The use of β-adrenergic blocking agents was not associated with prognosis. In Cox hazard model analysis, the increase in SBP (P < 0.002), HR at the 3rd minute after exercise (P < 0.05), and METs (P < 0.05) were independent predictors of mortality.SBP response to exercise, HR recovery after exercise, and METs obtained from the routine exercise test predicted mortality in patients with CHF irrespective of the use of β-adrenergic blocking agents. (Int Heart J 2010; 51: 111-115)

show abstract

Section: Discussionsupporting

confidence: 92%

Systolic Blood Pressure Response to Exercise as a Predictor of Mortality in Patients With Chronic Heart Failure

et al. 2010

View full text Add to dashboard Cite

show abstract

“…These discrepancies may be related to technical difficulties for examination, such as age, comorbidities, difficult to understand. Accordingly, there have been reports of dissociation between the value of VO 2PEAK and the prognosis of patients with severe heart disease [27][28][29] . In this study, this hypothesis was reinforced by the intolerance of many patients to the procedures required to perform CPET.…”

Section: Discussionmentioning

confidence: 99%

Treinamento aeróbico melhora a capacidade funcional de pacientes em hemodiálise crônica

Henrique¹,

Reboredo²,

Chaoubah³

et al. 2010

Arq. Bras. Cardiol.

View full text Add to dashboard Cite

show abstract

“…The ventilatory response to exercise most frequently measured by the V E/V CO 2 slope, as discussed above (see Minute Ventilation-Carbon Dioxide Output Relationship), has been found by several investigators to be even more predictive of outcome than peak V O 2 . [101][102][103][104] Unlike peak V O 2 , the V E/V CO 2 relation does not require a maximal effort. Similar to peak V O 2 , it is a continuous variable with no absolute cut point; however, the most commonly cited dichotomous threshold for the V E/V CO 2 slope is Ͼ34.…”

Section: Systolic Dysfunctionmentioning

confidence: 99%

Clinician’s Guide to Cardiopulmonary Exercise Testing in Adults

Balady¹,

Arena

Sietsema³

et al. 2010

Circulation

1,638

925

View full text Add to dashboard Cite

E xercise testing remains a remarkably durable and versatile tool that provides valuable diagnostic and prognostic information regarding patients with cardiovascular and pulmonary disease. Exercise testing has been available for more than a half century and, like many other cardiovascular procedures, has evolved in its technology and scope. When combined with exercise testing, adjunctive imaging modalities offer greater diagnostic accuracy, additional information regarding cardiac structure and function, and additional prognostic information. Similarly, the addition of ventilatory gas exchange measurements during exercise testing provides a wide array of unique and clinically useful incremental information that heretofore has been poorly understood and underutilized by the practicing clinician. The reasons for this are many and include the requirement for additional equipment (cardiopulmonary exercise testing [CPX] systems), personnel who are proficient in the administration and interpretation of these tests, limited or absence of training of cardiovascular specialists and limited training by pulmonary specialists in this technique, and the lack of understanding of the value of CPX by practicing clinicians.Modern CPX systems allow for the analysis of gas exchange at rest, during exercise, and during recovery and yield breath-by-breath measures of oxygen uptake (V O 2 ), carbon dioxide output (V CO 2 ), and ventilation (V E). These advanced computerized systems provide both simple and complex analyses of these data that are easy to retrieve and store, which makes CPX available for widespread use. These data can be readily integrated with standard variables measured during exercise testing, including heart rate, blood pressure, work rate, electrocardiography findings, and symptoms, to provide a comprehensive assessment of exercise tolerance and exercise responses. CPX can even be performed with adjunctive imaging modalities for additional diagnostic assessment. Hence, CPX offers the clinician the ability to obtain a wealth of information beyond standard exercise electrocardiography testing that when appropriately applied and interpreted can assist in the management of complex cardiovascular and pulmonary disease.

show abstract

Cardiopulmonary Exercise Testing Identifies Low Risk Patients With Heart Failure and Severely Impaired Exercise Capacity Considered for Heart Transplantation

Abstract: Peak exercise SBP and percent predicted peak exercise VO2 are two inexpensive and easily measured noninvasive variables that can be used to further prognostically risk stratify ambulatory patients with CHF referred for heart transplantation with a peak exercise VO2 < or = 14 ml/min per kg.

Cited by 148 publications

References 21 publications

Systolic Blood Pressure Response to Exercise as a Predictor of Mortality in Patients With Chronic Heart Failure

Systolic Blood Pressure Response to Exercise as a Predictor of Mortality in Patients With Chronic Heart Failure

Treinamento aeróbico melhora a capacidade funcional de pacientes em hemodiálise crônica

Clinician’s Guide to Cardiopulmonary Exercise Testing in Adults

Contact Info

Product

Resources

About