Evolving Role of Cardiopulmonary Exercise Testing in Heart Failure and Cardiac Transplantation

Agostoni, Piergiuseppe; Guazzi, Marco

doi:10.1159/000062213

Cited by 5 publications

(2 citation statements)

References 75 publications

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“…The rate of rise of exceeds the rate of rise of and so / starts to increase. This gives one method of determining the VAT from gas exchange measurements as AT is the point when the Ventilatory Equivalent for oxygen (/) increases relative to a constant Ventilatory Equivalent for carbon dioxide (/) [14] (Fig. 3).…”

Section: Physiology Of the Anaerobic Thresholdmentioning

confidence: 99%

Cardiopulmonary exercise testing as a risk assessment method in non cardio‐pulmonary surgery: a systematic review

Smith¹,

Stonell

Purkayastha³

et al. 2009

Anaesthesia

202

146

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SummaryThis study reviews the predictive value of maximum oxygen consumption ( _ VO 2 max ) and anaerobic threshold, obtained through cardiopulmonary exercise testing, in calculating peri-operative morbidity and mortality in non-cardiopulmonary thoraco-abdominal surgery. A literature review provided nine studies that investigated either one or both of these two variables across a wide range of surgical procedures. Six of the seven studies that reported sufficiently detailed results on peak oxygen consumption and four of the six studies that reported sufficiently detailed results on anaerobic threshold found them to be significant predictors. We conclude that peak oxygen consumption and possibly anaerobic threshold are valid predictors of peri-operative morbidity and mortality in non-cardiopulmonary thoraco-abdominal surgery. These indicators could potentially provide a means of allocating increased care to high-risk patients. Cardiopulmonary exercise testing (CPET or CPX) is a non-invasive, integrated assessment of cardiovascular and pulmonary function both at rest and under stress. Among the purported benefits is its ability to determine the ability of the subject's physiological capacity to cope with the metabolic demands created by the trauma of major surgery. During the test subjects are exposed to incremental physical exercise up to their maximally tolerated level, dictated either by exhaustion or symptom related cessation (e.g., breathlessness or angina). Several physiological variables are recorded including ventilatory parameters, inspiratory and expiratory gases, blood pressure (BP) and electrocardiogram (ECG). From these are derived two key indicators: the body's maximum oxygen uptake ( _ VO 2 max ) and the point at which anaerobic metabolism exceeds aerobic metabolism (Ventilatory Anaerobic Threshold or VAT). Together, these broadly indicate the ability of the cardiovascular system to deliver oxygen to the peripheral tissues and the ability of the tissues to utilise that oxygen. It has already been demonstrated that measures such as _ VO 2 max are useful predictors of postoperative complications of pulmonary resection surgery [1][2][3] and assessing the timing of cardiac transplant surgery [4], while the VAT is a predictor of postoperative cardiac complications in abdominal surgery [5]. Physiology of the anaerobic thresholdLactate accumulation in exercising muscle occurs when the muscle O 2 demand exceeds the supply. At this point the venous lactate concentration will begin to rise. This point is called the Lactate Anaerobic Threshold (LAT). The muscle lactate ⁄ pyruvate ratio increases at the LAT which supports the concept that the lactic acidosis results from relative muscle hypoxia [6][7][8].As an individual commences an incremental exercise test, their expired minute volume ( _ V E ), oxygen consumption per minute ( _ VO 2 ) and CO 2 production per minute ( _ VCO 2 ) all increase linearly with respect to variables such as work rate or time. However a point is reached when _ VCO 2 increases out of ...

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Section: Physiology Of the Anaerobic Thresholdmentioning

confidence: 99%

Cardiopulmonary exercise testing as a risk assessment method in non cardio‐pulmonary surgery: a systematic review

Smith¹,

Stonell

Purkayastha³

et al. 2009

Anaesthesia

202

146

View full text Add to dashboard Cite

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“…Somit kann die Effi zienz auch zur Objektivierung des Gehtests in dieser Patientengruppe angewendet werden. Best ä tigt werden diese Ergebnisse durch Untersuchungen von Agostoni und Guazzi [37] und einer doppelblinden Plazebo-kontrollierten Carvedilol-Studie [38] , die keinen wesentlichen Einfl uss der Betablocker-Therapie auf die Ergebnisse der ergospirometrisch erfassten Leistungsf ä higkeit zeigten. Auch Kroidl et al [39] stellen in ihrem Kursbuch Ergospirometrie fest, dass Betablocker keine relevanten Einschr ä nkungen in der Ergospirometrie bewirken.…”

Section: Auswirkungen Einer Betablocker-therapieunclassified

Effizienz als ein neuer Parameter zur Objektivierung der körperlichen Leistungsfähigkeit mittels 6-Minuten-Gehtest

Marek

Friz²,

Pohl³

et al. 2011

Rehabilitation

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The patient's performance of the second walk test with an unchanged distance at a lower heart frequency reveals an improved physical fitness. This is solely described by an increase of the parameter of efficiency, E. Calculation of this parameter delivers a quantification of the effect of exercise training irrespective of the patient's cooperation. Efficiency, hence, is a meaningful complement to the sole consideration of the distance walked in the assessment of physical fitness as a benefit of rehabilitation.

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Cardiopulmonary Exercise Testing and Prescription of Exercise

Christle

Arena

2020

Textbook of Sports and Exercise Cardiology

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Evolving Role of Cardiopulmonary Exercise Testing in Heart Failure and Cardiac Transplantation

Cited by 5 publications

References 75 publications

Cardiopulmonary exercise testing as a risk assessment method in non cardio‐pulmonary surgery: a systematic review

Cardiopulmonary exercise testing as a risk assessment method in non cardio‐pulmonary surgery: a systematic review

Effizienz als ein neuer Parameter zur Objektivierung der körperlichen Leistungsfähigkeit mittels 6-Minuten-Gehtest

Cardiopulmonary Exercise Testing and Prescription of Exercise

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