Correlates and prognostic implication of exercise capacity in chronic congestive heart failure

Szlachcic, Jadwiga; Masse, Barry M.; Kramer, Barry; Topic, Nina; Tubau, Julio F.

doi:10.1016/0002-9149(85)90742-8

Cited by 472 publications

(152 citation statements)

References 14 publications

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“…KLEBER et al [226] reported a better prognosis at 30 months for patients with V9O 2 ,peak .45% pred. SZLACHCIC et al [227] reported that V9O 2 ,peak ,10 mL?min -1 ?kg -1 is associated with 77% mortality at 1 yr, while in patients with V9O 2 ,peak .10 mL?min -1 ?kg -1 mortality rate at 1 yr is ,20%. More recently, GITT et al [138] reported that CHF patients with V9O 2 ,peak f14 mL?min -1 ?kg -1 (or f50% pred) had a three-fold increased risk of death at 6 months [138].…”

Section: V9o 2 Peak and Ventilatory Indicesmentioning

confidence: 97%

Recommendations on the use of exercise testing in clinical practice

Palange¹,

Ward²,

Carlsen³

et al. 2006

Eur Respir J

560

390

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Evidence-based recommendations on the clinical use of cardiopulmonary exercise testing (CPET) in lung and heart disease are presented, with reference to the assessment of exercise intolerance, prognostic assessment and the evaluation of therapeutic interventions (e.g. drugs, supplemental oxygen, exercise training). A commonly used grading system for recommendations in evidence-based guidelines was applied, with the grade of recommendation ranging from A, the highest, to D, the lowest.For symptom-limited incremental exercise, CPET indices, such as peak O 2 uptake (V9O 2 ), V9O 2 at lactate threshold, the slope of the ventilation-CO 2 output relationship and the presence of arterial O 2 desaturation, have all been shown to have power in prognostic evaluation. In addition, for assessment of interventions, the tolerable duration of symptom-limited high-intensity constant-load exercise often provides greater sensitivity to discriminate change than the classical incremental test. Field-testing paradigms (e.g. timed and shuttle walking tests) also prove valuable.In turn, these considerations allow the resolution of practical questions that often confront the clinician, such as: 1) ''When should an evaluation of exercise intolerance be sought?''; 2) ''Which particular form of test should be asked for?''; and 3) ''What cluster of variables should be selected when evaluating prognosis for a particular disease or the effect of a particular intervention?''

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Section: V9o 2 Peak and Ventilatory Indicesmentioning

confidence: 97%

Recommendations on the use of exercise testing in clinical practice

Palange¹,

Ward²,

Carlsen³

et al. 2006

Eur Respir J

560

390

View full text Add to dashboard Cite

show abstract

“…Several potential prognostic markers, including gender, age, sex, etiology, left ventricular ejection fraction (LVEF), transmitral filling E/A wave ratio, E-wave deceleration time (DT), mitral and tricuspid regurgitation, pulmonary wedge pressure (PWP), peak exercise oxygen consumption (VO 2 max), levels of plasma norepinephrine, atrial and B-type natriuretic peptides (ANP, BNP), heart fatty acid binding protein (H-FABP), have been widely reported in patients with severe cardiac failure (50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63)(64). However, the predictors of outcomes varied from study to study and in most of them long-term (>24 month) outcomes were chosen.…”

Section: Prognostic Markers In End-stage Dcmmentioning

confidence: 99%

Prediction of Short-Term Outcomes in Patients With Idiopathic Dilated Cardiomyopathy Referred for Transplantation Using Standard Echocardiography and Strain Imaging

Jasaitytė

Dandel

Lehmkuhl

et al. 2009

Transplantation Proceedings

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“…Fundamentally, it is the intricate interplay of the heart and lung function that determines clinical outcomes among patients with LVSD. Cardiopulmonary exercise testing, which comprehensively measures the expiratory ventilation, pulmonary gas exchange, and cardiac output is one of the best predictors of adverse clinical outcomes for patients with chronic heart failure supporting the critical role of heart and lung interaction in heart failure pathophysiology 43, 44, 45, 46, 47, 48. Our cohort consisted of community‐dwelling older adults without history of heart failure.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular and Mortality Outcomes in the Elderly With Impaired Cardiac and Pulmonary Function: The Cardiovascular Health Study (CHS)

Waheed

Chaves

Gardin

et al. 2015

JAHA

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BackgroundImpaired pulmonary function (IPF) and left ventricular systolic dysfunction (LVSD) are prevalent in the elderly and are associated with significant morbidity and mortality. The main objectives of this study were to examine the relative impact and joint association of IPF and LVSD with heart failure, cardiovascular mortality and all‐cause mortality, and their impact on risk classification using a continuous net reclassification index.Methods and ResultsWe followed 2342 adults without prevalent cardiovascular disease (mean age, 76 years) from the Cardiovascular Health Study for a median of 12.6 years. LVSD was defined as LV ejection fraction <55%. IPF was defined as: forced expiratory volume in 1 second:forced vital capacity <70%, and predicted forced expiratory volume in 1 second <80%. Outcomes included heart failure hospitalization, cardiovascular mortality, all‐cause mortality, and composite outcome. LVSD was detected in 128 subjects (6%), IPF in 441 (19%) and both in 38 (2%). Compared to those without LVSD or IPF, there was a significantly increased cardiovascular risk for groups of LVSD only, IPF only, and LVSD plus IPF, adjusted hazard ratio (95% CI) 2.1 (1.5–3.0), 1.7 (1.4–2.1), and 3.2 (2.0–5.1) for HF; 1.8 (1.2–2.6), 1.4 (1.1–1.8), and 2.8 (1.7–4.7) for cardiovascular mortality; 1.3 (1.0–1.8), 1.7 (1.4–1.9), and 2.1 (1.5–3.0) for all‐cause mortality, and 1.6 (1.3–2.1), 1.7 (1.5–1.9), and 2.4 (1.7–3.3) for composite outcome, respectively. Risk classification improved significantly for all outcomes when IPF was added to the adjusted model with LVSD or LVSD to IPF.ConclusionsWhile risk of cardiovascular outcomes was the highest among elderly with both LVSD and IPF, risk was comparable between subjects with IPF alone and those with LVSD alone. This observation, combined with improved risk classification by adding IPF to LVSD or LVSD to IPF, underscore the importance of comprehensive heart and lung evaluation in cardiovascular outcome assessment.

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Correlates and prognostic implication of exercise capacity in chronic congestive heart failure

Cited by 472 publications

References 14 publications

Recommendations on the use of exercise testing in clinical practice

Recommendations on the use of exercise testing in clinical practice

Prediction of Short-Term Outcomes in Patients With Idiopathic Dilated Cardiomyopathy Referred for Transplantation Using Standard Echocardiography and Strain Imaging

Cardiovascular and Mortality Outcomes in the Elderly With Impaired Cardiac and Pulmonary Function: The Cardiovascular Health Study (CHS)

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