Prognostic Value of Oxygen Kinetics During Recovery From Cardiopulmonary Exercise Testing in Patients With Chronic Heart Failure

Fortin, Marc; Turgeon, Pierre Yves; Nadreau, Éric; Grégoire, Philippe; Maltais, Louis-Gabriel; Sénéchal, Mario; Provencher, Steeve; Maltais, François

doi:10.1016/j.cjca.2015.02.015

Cited by 26 publications

(25 citation statements)

References 21 publications

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“…8,14 For instance, Laukannen et al 28 found a 2.76 and 3.09 higher risk, respectively, of all-cause and cardiovascular death in a cohort of Finnish men, on the basis of VO 2 max measurements. 8,14 For instance, Laukannen et al 28 found a 2.76 and 3.09 higher risk, respectively, of all-cause and cardiovascular death in a cohort of Finnish men, on the basis of VO 2 max measurements.…”

Section: Discussionmentioning

confidence: 99%

“…1---6 Previous studies have indicated the prognostic importance of several CPET ventilatory variables, 7 including maximum oxygen uptake (VO 2 max), 8 ventilatory anaerobic threshold (VAT), 9 oxygen uptake efficiency slope (OUES) 10,11 and ventilatory equivalent for CO 2 (VE/VCO 2 ), 12,13 as well as in the immediate recovery after CPET, such as the recently proposed O 2 kinetics. 14 While a submaximal measure of exercise performance may be useful in adults who are physiologically unable to reach a peak level of exercise, such theoretical utility is often offset by methodological limitations in the assessment of some of these variables. 15 The cardiorespiratory optimal point (COP) constitutes a novel submaximal CPET index which provides an alternative approach to respiratory physiology.…”

Section: Copmentioning

confidence: 99%

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Cardiorespiratory optimal point during exercise testing as a predictor of all-cause mortality

Ramos

Araújo

2017

Revista Portuguesa de Cardiologia (English Edition)

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Introduction and Aim: The cardiorespiratory optimal point (COP) is a novel index, calculated as the minimum oxygen ventilatory equivalent (VE/VO 2 ) obtained during cardiopulmonary exercise testing (CPET). In this study we demonstrate the prognostic value of COP both independently and in combination with maximum oxygen consumption (VO 2 max) in community-dwelling adults. Methods: Maximal cycle ergometer CPET was performed in 3331 adults (66% men) aged 40-85 years, healthy (18%) or with chronic disease (81%). COP cut-off values of <22, 22-30, and >30 were selected based on the log-rank test. Risk discrimination was assessed using COP as an independent predictor and combined with VO 2 max. Results: Median follow-up was 6.4 years (7.1% mortality). Subjects with COP >30 demonstrated increased mortality compared to those with COP <22 (hazard ratio [HR] 6.86, 95% confidence interval [CI] 3.69-12.75, p<0.001). Multivariate analysis including gender, age, body mass index, and the forced expiratory volume in 1 s/vital capacity ratio showed adjusted HR for COP >30 of 3.72 (95% CI 1.98-6.98; p<0.001) and for COP 22-30 of 2.15 (95% CI 1.15-4.03, p<0.001). Combining COP and VO 2 max data further enhanced risk discrimination. Conclusions: COP >30, either independently or in combination with low VO 2 max, is a good predictor of all-cause mortality in community-dwelling adults (healthy or with chronic disease). COP is a submaximal prognostic index that is simple to obtain and adds to CPET assessment, especially for adults unable or unwilling to achieve maximal exercise. Consumo de oxigênio; Exercício; Ventilação; Teste cardiopulmonar de exercício Ponto ótimo cardiorrespiratório como preditor de mortalidade por todas as causas Resumo Introdução e objetivos: O ponto ótimo cardiorrespiratório (POC) representa o menor valor do equivalente ventilatório de oxigênio (VE/VO2), obtido durante um teste cardiopulmonar de exercício (TCPE). Neste estudo, demonstramos a utilidade prognóstica do POC de forma independente e associado ao VO2max. Métodos: Foram avaliados TCPE máximos em cicloergômetro de 3331 adultos (66% homens) com idades entre 40-85 anos, saudáveis (18%) e com doenças crônicas (81%). Ao POC foram atribuídos pontos de corte para a criação de grupos < 22, 22-30 e > 30, com base no teste logrank. As associações de risco foram verificadas por meio de regressões de Cox, utilizando o POC como preditor independente e combinado com VO2max. Resultados: O seguimento médio foi de 6,4 anos (7,1% das mortes). Indivíduos com POC > 30 demonstraram maior mortalidade, em comparação com POC < 22; HR = 6,86 (intervalo de confiança [IC] 95% = 3,69-12,75, p < 0,001). A análise multivariada ajustada, incluindo idade, sexo, índice de massa corporal, e a capacidade vital 1-s volume expiratório forçado mostraram HR POC > 30 de 3,72 (IC 95% = 1,98-6,98; p < 0,001) e para a POC 22-30 de 2,15 (IC 95% = 1,15-4,03, p < 0,001). Combinando POC e VO2max, aumentou-se a discriminação do risco. Conclusões: O POC > 30, de forma independente ou combinado com baixo...

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Section: Discussionmentioning

confidence: 99%

Section: Copmentioning

confidence: 99%

Cardiorespiratory optimal point during exercise testing as a predictor of all-cause mortality

Ramos

Araújo

2017

Revista Portuguesa de Cardiologia (English Edition)

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“…In addition, the rate of recovery of . VO 2 at 2 minutes after exercise has been shown to be the strongest prognostic factor of major cardiac events, such as death, heart transplantation, and mechanical heart implantation in severe CHF patients (10).…”

Section: Introductionmentioning

confidence: 99%

Effects of high- and moderate-intensity exercise on central hemodynamic and oxygen uptake recovery kinetics in CHF-COPD overlap

Mazzuco

Souza

Medeiros

et al. 2020

Braz J Med Biol Res

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The oxygen uptake ( . VO 2 ) kinetics during onset of and recovery from exercise have been shown to provide valuable parameters regarding functional capacity of both chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) patients. To investigate the influence of comorbidity of COPD in patients with CHF with reduced ejection fraction on recovery from submaximal exercise, 9 CHF-COPD male patients and 10 age-, gender-, and left ventricle ejection fraction (LVEF)-matched CHF patients underwent constant-load exercise tests (CLET) at moderate and high loads. The . VO 2 , heart rate (HR), and cardiac output (CO) recovery kinetics were determined for the monoexponential relationship between these variables and time. Within-group analysis showed that the recovery time constant of HR (Po0.05, d=1.19 for CHF and 0.85 for CHF-COPD) and CO (Po0.05, d=1.68 for CHF and 0.69 for CHF-COPD) and the mean response time (MRT) of CO (Po0.05, d=1.84 for CHF and 0.73 for CHF-COPD) were slower when moderate and high loads were compared. CHF-COPD patients showed smaller amplitude of CO recovery kinetics (Po0.05) for both moderate (d=2.15) and high (d=1.07) CLET. Although the recovery time constant and MRT means were greater in CHF-COPD, CHF and CHF-COPD groups were not differently affected by load (P40.05 in group vs load analysis). The ventilatory efficiency was related to MRT of . VO 2 during high CLET (r=0.71). Our results suggested that the combination of CHF and COPD may further impair the recovery kinetics compared to CHF alone.

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“…The recovery period has been widely studied in healthy individuals and patients with cardiac disease [7–9]. For example, the

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O 2 kinetics during recovery after submaximal and maximal exercise is prolonged in heart failure patients and closely correlated with indicators of physical fitness ( e.g.…”

Section: Introductionmentioning

confidence: 99%

Early-Phase Recovery of Cardiorespiratory Measurements after Maximal Cardiopulmonary Exercise Testing in Patients with Chronic Obstructive Pulmonary Disease

et al. 2016

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Background. This study investigated respiratory gas exchanges and heart rate (HR) kinetics during early-phase recovery after a maximal cardiopulmonary exercise test (CPET) in patients with chronic obstructive pulmonary disease (COPD) grouped according to airflow limitation. Methods. Thirty control individuals (control group: CG) and 81 COPD patients (45 with “mild” or “moderate” airflow limitation, COPDI-II, versus 36 with “severe” or “very severe” COPD, COPDIII-IV) performed a maximal CPET. The first 3 min of recovery kinetics was investigated for oxygen uptake (V˙O2), minute ventilation (V˙E), respiratory equivalence, and HR. The time for V˙O2 to reach 25% (T1/4 V˙O2) of peak value was also determined and compared. Results. The V˙O2, V˙E, and HR recovery kinetics were significantly slower in both COPD groups than CG (p < 0.05). Moreover, COPDIII-IV group had significantly higher V˙O2 and V˙E during recovery than COPDI-II group (p < 0.05). T1/4 V˙O2 significantly differed between groups (p < 0.01; 58 ± 18 s in CG, 79 ± 26 s in COPDI-II group, and 121 ± 34 s in COPDIII-IV) and was significantly correlated with forced expiratory volume in one second in COPD patients (p < 0.001, r = 0.53) and with peak power output (p < 0.001, r = 0.59). Conclusion. The COPD groups showed slower kinetics in the early recovery period than CG, and the kinetics varied with severity of airflow obstruction.

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Prognostic Value of Oxygen Kinetics During Recovery From Cardiopulmonary Exercise Testing in Patients With Chronic Heart Failure

Cited by 26 publications

References 21 publications

Cardiorespiratory optimal point during exercise testing as a predictor of all-cause mortality

Cardiorespiratory optimal point during exercise testing as a predictor of all-cause mortality

Effects of high- and moderate-intensity exercise on central hemodynamic and oxygen uptake recovery kinetics in CHF-COPD overlap

Early-Phase Recovery of Cardiorespiratory Measurements after Maximal Cardiopulmonary Exercise Testing in Patients with Chronic Obstructive Pulmonary Disease

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