| Exercise testing in heart failure. A critical review. | |
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MedLine Citation:
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PMID: 7523058 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Exercise intolerance is one of the primary characteristics of chronic congestive heart failure (CHF). Therefore, exercise testing has been widely used in the assessment of CHF patients, both to define the severity of the disease and to assess the efficacy of pharmaceutical agents in clinical trials. A number of different exercise tests can be used, although maximal exercise testing is the most common. Maximal exercise capacity can be determined by measuring exercise duration during incremental exercise, or maximal oxygen (O2) consumption, or it can be estimated by anaerobic threshold. While baseline exercise testing in CHF patients accurately identifies and quantifies cardiac failure and determines prognosis, it is of limited value in assessing changes that occur as a result of drug therapy. A key drawback of exercise testing as a measurement of drug effect is the fact that exercise changes produced by drug intervention do not correlate well with changes in the mortality rate. Several examples of the lack of correlation between exercise testing and mortality rates have been observed in clinical trials with angiotensin converting enzyme (ACE) inhibitors and vasodilators. ACE inhibitors have a modest effect on maximal exercise capacity but they improve survival. It is thought that neuroendocrine activation more closely reflects mortality rates and also the changes in survival observed with pharmacological intervention compared with other modes of evaluation. |
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Authors:
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K Swedberg |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Drugs Volume: 47 Suppl 4 ISSN: 0012-6667 ISO Abbreviation: Drugs Publication Date: 1994 |
Date Detail:
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Created Date: 1994-10-27 Completed Date: 1994-10-27 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7600076 Medline TA: Drugs Country: NEW ZEALAND |
Other Details:
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Languages: eng Pagination: 14-24 Citation Subset: IM |
Affiliation:
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Department of Medicine, Göteborg University, Ostra Hospital, Sweden. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angiotensin-Converting Enzyme Inhibitors
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adverse effects,
therapeutic use* Clinical Trials as Topic Exercise / physiology Exercise Test Heart Failure / diagnosis, drug therapy*, physiopathology* Humans Neurosecretory Systems / physiology Oxygen Consumption Prognosis Ramipril / adverse effects Severity of Illness Index Vasodilator Agents / therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin-Converting Enzyme Inhibitors; 0/Vasodilator Agents; 87333-19-5/Ramipril |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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