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Metabolic parameters derived from cardiopulmonary stress testing for prediction of prognosis in patients with heart failure: the ochsner experience.
MedLine Citation:
PMID:  21603413     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Cardiopulmonary parameters, particularly peak oxygen consumption, have proven utility in prognostic stratification for patients with heart failure. These have been typically corrected for total body weight as opposed to lean body mass (LBM). For practical purposes, fat consumes virtually no oxygen and receives minimal perfusion. Based on this rationale and on observations from previous studies, several investigations conducted at the Ochsner Clinic Foundation have assessed the prognostic value of metabolic parameters when corrected for LBM. Three studies reviewed in this discussion consistently found greater prognostic value for LBM-corrected parameters, especially peak oxygen consumption and oxygen pulse. These findings lead to a strong recommendation for LBM correction of cardiopulmonary exercise stress test-derived parameters for more accurate prognostic stratification in patients with heart failure, especially in the obese population. Other centers have studied additional parameters such as the ventilation to carbon dioxide production slope, oxygen uptake efficiency slope, and partial pressure of end-tidal carbon dioxide during exercise and rest. In multiple studies, these ventilation-dependent parameters have shown prognostic superiority compared with the standard peak oxygen consumption even when obtained from submaximal exercise data. However, no study to our knowledge has compared these parameters with LBM-adjusted values as described herein. The prognostic validity of cardiopulmonary exercise stress test-derived parameters requires further investigation in patients treated with β-blockers.
Authors:
Joaquin Crespo; Carl J Lavie; Richard V Milani; Yvonne E Gilliland; Hamang M Patel; Hector O Ventura
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Ochsner journal     Volume:  9     ISSN:  1524-5012     ISO Abbreviation:  Ochsner J     Publication Date:  2009  
Date Detail:
Created Date:  2011-05-23     Completed Date:  2011-07-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101125795     Medline TA:  Ochsner J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  46-53     Citation Subset:  -    
Affiliation:
Cardiac Rehabilitation and Exercise Laboratories, Ochsner Clinic Foundation, New Orleans, LA.
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