EXERCISE TESTING IN THE ASSESSMENT OF CHRONIC CONGESTIVE HEART FAILURE

• Published in: Heart (British Cardiac Society) Vol. 88; no. 5; pp. 538 - 543
• Main Authors: Lainchbury, John G, Richards, A Mark
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01.11.2002; BMJ; BMJ Publishing Group Ltd; BMJ Publishing Group LTD; Copyright 2002 by Heart
• Subjects: Biological and medical sciences; Cardiac arrhythmia; Cardiology. Vascular system; Congestive heart failure; Education in Heart; Evaluation; Exercise; Exercise Test - methods; exercise testing; Fitness equipment; Heart; Heart attacks; Heart failure; Heart Failure - diagnosis; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Heart rate; Humans; Influence; Medical prognosis; Medical sciences; Mortality; Multivariate analysis; natriuretic peptides; Patients; peak oxygen uptake; Peptides; Physiological aspects; Plasma; Prognosis; Survival Analysis; Testing; Workloads; New Zealand; Physical exercise; Human; Heart failure; Physical performance; Pathophysiology; Heart disease; Cardiovascular disease; Exercise tolerance test; Exploration; Technique
• ISSN: 1355-6037; 1468-201X; 1468-201X
• DOI: 10.1136/heart.88.5.538

Exercise testing in assessing CHF: key points [black right triangle] Exercise testing with monitoring of gas exchange parameters provides useful information on exercise capacity and prognosis in heart failure; in addition it is helpful in establishing the cause of exercise limitation [black right triangle] Both treadmill and bicycle protocols are acceptable, but attention to technical aspects of exercise testing are important in order to obtain maximum exercise data [black right triangle] Peak V* o 2 is probably the strongest predictor of prognosis in heart failure but other exercise, clinical, and hormonal data must be taken into account in arriving at an assessment of prognosis. [black right triangle] In subjects unable to perform a maximal exercise test submaximal data such as the slope of the relation between V*E and V* co 2 may be useful [black right triangle] Further studies of the response of neurohormones to exercise may add to the utility of exercise tests in assessing prognosis We have undertaken a study in 68 patients with NYHA class III-IV heart failure and average pV* o 2 of 13.6 ml/kg/min. [...]preliminary data suggest combining maximum exercise testing with assessment of neurohormones (particularly the natriuretic peptides both at rest and at peak exercise) may be valuable.