Document Detail


Can anaerobic threshold be used as an end-point for therapeutic trials in heart failure? Lessons from a multicentre randomized placebo-controlled trial. The VO2 French Study Group.
MedLine Citation:
PMID:  8005126     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Anaerobic threshold (AT), proposed as a non-invasive index of exercise tolerance, independent of patient motivation, is considered more reliable than exercise duration in assessing the effect of drug therapy in chronic heart failure (CHF). However, inter-observer variation in patients may be more difficult than in normal subjects. In a multicentre study, 85 patients from 10 centres performed a total of 331 bicycle maximal tests (ramp protocols, 10 watts.min-1) with respiratory gas analysis by different systems. A central committee reviewed all the tests. Percentages of AT determination ranged from 34% to 71% depending on the method used. Apart from the respiratory exchange ratio (RER) method, which yielded the lowest rate of determination: 34%, and the crossing point (when RER = 1), which yielded the highest rate, 71%, other methods of determination, such as carbon dioxide (42%), minute ventilation (52%) or ventilatory equivalents plotted vs time (57%), did not differ in the rate of AT determination. Thus, even among trained physicians, AT determination was not reliable. The crossing point may nevertheless be a valuable index from a pragmatic standpoint, although it occurs after the actual AT. Peak oxygen uptake should remain the main end-point in assessment of exercise capacity.
Authors:
A Cohen-Solal; J F Aupetit; P Gueret; H Kolsky; F Zannad
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European heart journal     Volume:  15     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1994 Feb 
Date Detail:
Created Date:  1994-07-18     Completed Date:  1994-07-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  236-41     Citation Subset:  IM    
Affiliation:
Service de Cardiologie, Hôpital Beaujon, Clichy, France.
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MeSH Terms
Descriptor/Qualifier:
Anaerobic Threshold / drug effects*,  physiology
Angiotensin-Converting Enzyme Inhibitors / adverse effects,  therapeutic use*
Double-Blind Method
Exercise Test / drug effects*
Heart Failure / drug therapy*,  physiopathology
Humans
Lactates / blood
Lactic Acid
Oxygen / blood
Reproducibility of Results
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Lactates; 50-21-5/Lactic Acid; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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