Prognostic Power of Ventilatory Responses During Submaximal Exercise in Patients With Chronic Heart Disease

Koike, Atsushi; Itoh, Hidenori; Katô, Makoto; Sawada, Hitoshi; Aizawa, Tadanori; Fu, Long Tai; Watanabe, Hiroshi

doi:10.1378/chest.121.5.1581

Cited by 72 publications

(65 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The peak _ VO 2 and PETCO 2 at peak exercise were defined as the average values obtained during the last 15 s of incremental exercise. The ratio of the increase in _ VO 2 to the increase in work rate (D _ VO 2 /DWR) was calculated by a least-squares linear regression from the data recorded between 30 s after the start of incremental exercise to 30 s before the end of the exercise [15]. The _ VE/ _ VCO 2 slope was calculated from the start of incremental exercise to the respiratory compensation point by the least-squares linear regression [15].…”

Section: Discussionmentioning

confidence: 99%

“…The ratio of the increase in _ VO 2 to the increase in work rate (D _ VO 2 /DWR) was calculated by a least-squares linear regression from the data recorded between 30 s after the start of incremental exercise to 30 s before the end of the exercise [15]. The _ VE/ _ VCO 2 slope was calculated from the start of incremental exercise to the respiratory compensation point by the least-squares linear regression [15]. The respiratory compensation point was determined using the following criteria: (1) the ratio of _ VE to _ VCO 2 starts to increase after a period of decrease or stasis; and (2) the PETCO 2 starts to decrease after a period of stasis.…”

Section: Discussionmentioning

confidence: 99%

“…The respiratory compensation point was determined using the following criteria: (1) the ratio of _ VE to _ VCO 2 starts to increase after a period of decrease or stasis; and (2) the PETCO 2 starts to decrease after a period of stasis. When the respiratory compensation point could not be clearly identified, the _ VE/ _ VCO 2 slope was calculated from the data recorded between the start of incremental exercise to the end of the exercise [15]. PETCO 2 at rest was also determined as the average of the value obtained as the subject sat on the ergometer over a 4-min period before the start of the exercise test.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Prognostic value of end-tidal CO2 pressure during exercise in patients with left ventricular dysfunction

et al. 2008

Self Cite

View full text Add to dashboard Cite

We compared the prognostic power of end-tidal CO 2 pressure (PETCO 2 ) during exercise, an index of arterial CO 2 pressure, with those of established respiratory gas indexes during exercise testing in patients with left ventricular dysfunction. Seventy-eight consecutive patients with a left ventricular ejection fraction (LVEF) B40% were enrolled in the study. All the patients performed a symptom-limited incremental exercise test with respiratory gas measurements. PETCO 2 at peak exercise, peak O 2 uptake ( _ VO 2 ), the ratio of the increase in ventilation to the increase in CO 2 output ( _ VE/ _ VCO 2 slope), and the ratio of the increase in _ VO 2 to the increase in work rate (D _ VO 2 / DWR) were measured. PETCO 2 at peak exercise was significantly correlated with peak _ VO 2 , _ VE/ _ VCO 2 slope and D _ VO 2 /DWR. During a prospective follow-up period of 992 ± 570 days, 14 cardiac deaths occurred. As compared to survivors, non-survivors had a significantly lower LVEF, lower PETCO 2 at peak exercise, lower peak _ VO 2 , lower D _ VO 2 /DWR and a higher _ VE/ _ VCO 2 slope. Among these indexes, only PETCO 2 at peak exercise was found to be an independent predictor for cardiac death. PETCO 2 at peak exercise is useful in predicting poor prognosis in patients with left ventricular systolic dysfunction.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic value of end-tidal CO2 pressure during exercise in patients with left ventricular dysfunction

et al. 2008

Self Cite

View full text Add to dashboard Cite

show abstract

“…The calculator then adjusts for estimated glomerular filtration rate. 4 Physical fitness [12,[30][31][32][33][34][35][36][37][38][39][40][41]. The final adjustment is for physical fitness.…”

mentioning

confidence: 99%

Pre‐operative co‐morbidity and postoperative survival in the elderly: beyond one lunar orbit

Carlisle

2013

Anaesthesia

View full text Add to dashboard Cite

SummaryMortality is a good measure of killing, but it is a poor measure of cure, palliation or the maintenance of function. Nevertheless, it has remained the primary metric of hospital care for 200 years. This article discusses the factors that contribute to mortality risk and survival trajectories, as well as the increasing recognition that surgery kills for months after the last suture is tied. This article discusses how disparate factors can usefully combine to generate an 'elderly' group with a monthly mortality in excess of 1% and a median life expectancy less than 3.5 years. A downloadable spreadsheet is provided that combines risk factors to generate mortality risks and their associated survival curves, emphasising the importance of looking beyond one postoperative month. If the function of a hospital were to kill the sick, statistical comparisons of this nature would be admissible.-Florence Nightingale, 1859 [1] Mortality is an insensitive measure of care: most patients survive the postoperative period, whilst (perhaps) many observed deaths are not associated with poor care. We should concentrate on the living, not the dead. Unfortunately, information on the effect surgery has on people's lives is scarce, in comparison with how often it kills them. This paper discusses how to estimate the chance that someone will die and how much this might change following surgery, but in so doing, we might reflect on Florence Nightingale's observation that mortality is an excellent measure of performance only for those trying to kill. Chance (at least in part) determines survival and death, which can be estimated using certain characteristics throughout adulthood: age; sex; historical morbidity; and physiological function [2][3][4][5][6][7][8][9][10][11][12]. The latter two characteristics are meant in their broadest sense, so that together they might accommodate variables that are, or might be, independently associated with survival. For instance, socioeconomic status is an historical characteristic that confers morbidity and mortality risks, whereas brain natriuretic peptide (BNP) is a marker of physiological function that might be shown to have an independent prognostic value. Crucially, variables used in the calculation should have a known independent effect on long-term survival in the general, non-surgical population, so that all the purposes of pre-operative mortality estimation are served (see below). Variables, such as BNP, have yet to declare their value in promoting the precision of perioperative prognostication, because their relationship with general survival has been inadequately described.It is one's risk of death, rather than one's proximity to birth, that determines the trajectory of one's remain-

show abstract

“…Several studies have demonstrated the prognostic relevance of oxygen uptake kinetics in heart failure, [15][16][17][18][19] hence it is relevant that in this issue of the Netherlands Heart Journal a review about oxygen uptake kinetics is published. 5 The paper by Kemps and colleagues stresses the potential importance of oxygen onset and recovery kinetics for the clinical management of CHF patients, for risk assessment, and, equally or even more important, to measure the effect of therapeutic interventions.…”

mentioning

confidence: 99%

Oxygen uptake in heart failure: how much, how fast?

Gademan¹,

Laarse²,

Swenne³

et al. 2009

NHJL

View full text Add to dashboard Cite

Prognostic Power of Ventilatory Responses During Submaximal Exercise in Patients With Chronic Heart Disease

Cited by 72 publications

References 33 publications

Prognostic value of end-tidal CO2 pressure during exercise in patients with left ventricular dysfunction

Prognostic value of end-tidal CO2 pressure during exercise in patients with left ventricular dysfunction

Pre‐operative co‐morbidity and postoperative survival in the elderly: beyond one lunar orbit

Oxygen uptake in heart failure: how much, how fast?

Contact Info

Product

Resources

About