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Comparison of three methods to identify the anaerobic threshold during maximal exercise testing in patients with chronic heart failure.
MedLine Citation:
PMID:  22248807     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: Exercise training efficiently improves peak oxygen uptake (V˙O2peak) in patients with chronic heart failure. To optimize training-derived benefit, higher exercise intensities are being explored. The correct identification of anaerobic threshold is important to allow safe and effective exercise prescription.
DESIGN: During 48 cardiopulmonary exercise tests obtained in patients with chronic heart failure (59.6 ± 11 yrs; left ventricular ejection fraction, 27.9% ± 9%), ventilatory gas analysis findings and lactate measurements were collected. Three technicians independently determined the respiratory compensation point (RCP), the heart rate turning point (HRTP) and the second lactate turning point (LTP2). Thereafter, exercise intensity (target heart rate and workload) was calculated and compared between the three methods applied.
RESULTS: Patients had significantly reduced maximal exercise capacity (68% ± 21% of predicted V˙O2peak) and chronotropic incompetence (74% ± 7% of predicted peak heart rate). Heart rate, workload, and V˙O2 at HRTP and at RCP were not different, but at LTP2, these parameters were significantly (P < 0.0001) higher. Mean target heart rate and target workload calculated using the LTP2 were 5% and 12% higher compared with those calculated using HRTP and RCP, respectively. The calculation of target heart rate based on LTP2 was 5% and 10% higher in 12 of 48 (25%) and 6 of 48 (12.5%) patients, respectively, compared with the other two methods.
CONCLUSIONS: In patients with chronic heart failure, RCP and HRTP, determined during cardiopulmonary exercise tests, precede the occurrence of LTP2. Target heart rates and workloads used to prescribe tailored exercise training in patients with chronic heart failure based on LTP2 are significantly higher than those derived from HRTP and RCP.
Authors:
Paul J Beckers; Nadine M Possemiers; Emeline M Van Craenenbroeck; An M Van Berendoncks; Kurt Wuyts; Christiaan J Vrints; Viviane M Conraads
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists     Volume:  91     ISSN:  1537-7385     ISO Abbreviation:  Am J Phys Med Rehabil     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8803677     Medline TA:  Am J Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  148-55     Citation Subset:  AIM; IM    
Affiliation:
From the Department of Cardiology, Antwerp University Hospital, Edegem, Belgium (PJB, NMP, EMVC, AMVB, KW, CJV, VMC); and University of Antwerp, Wilrijk, Belgium (PJB, EMVC, AMVB, CJV, VMC).
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