Document Detail


The cardiopulmonary exercise test is safe and reliable in elderly patients with chronic heart failure.
MedLine Citation:
PMID:  17667032     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To assess safety and feasibility of cardiopulmonary exercise test (CPX) in elderly patients with chronic heart failure (CHF) and left ventricular dysfunction. METHODS AND RESULTS: We analysed 395 cardiopulmonary exercise tests (CPXs) performed in 227 clinically stable patients with CHF [mean age 76 years, males 70%, mean New York Heart Association (NYHA) class 2.2 +/- 0.5] and impaired left ventricular function (mean ejection fraction 43 +/- 12%). Ninety-eight out of 395 CPXs (25%) were performed in patients older than 80 years. A standard bicycle exercise ramp protocol was used, with increments of 10 W/min. An expiratory exchange ratio (RER) >or= 1.05 at the peak of CPX was considered as the index of maximal exercise. Average workload was 65 +/- 23 W. No adverse reactions were observed, although one test was stopped for non-sustained ventricular tachycardia. The main reasons for stopping were exhaustion (50%), dyspnoea (30%), maximal predicted heart rate (17%), orthopaedic problems (2.5%) and significant ST segment depression (0.5%). In the overall cohort, 80% of patients achieved an RER >or= 1.05 and, in 56% of them, the RER was >or= 1.15. The anaerobic threshold (AT) was detectable in 80% of CPXs, and mean oxygen consumption (VO2) at AT was 9 +/- 6 ml/kg per min, whereas mean peak VO2 was 11 +/- 3 ml/kg per min. In the cohort of patients aged > 80 years, 71% reached an RER >or= 1.05 and 47% reached an RER >or= 1.15. In these older patients, AT was detectable in 68% of CPXs performed, and the mean peak VO2 was 10 +/- 3 ml/kg per min. CONCLUSIONS: In elderly patients with CHF, the CPX is safe, feasible and able to provide basic information for individual risk assessment. These findings potentially extend the indications of CPX, which is currently applied to selected middle-aged patients with CHF, to the elderly population.
Authors:
Angela Beatrice Scardovi; Claudio Coletta; Renata De Maria; Silvia Perna; Nadia Aspromonte; Marina Feola; Gianluca Rosso; Manuela Greggi; Vincenzo Ceci
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  8     ISSN:  1558-2027     ISO Abbreviation:  J Cardiovasc Med (Hagerstown)     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-01     Completed Date:  2007-09-21     Revised Date:  2009-05-28    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  608-12     Citation Subset:  IM    
Affiliation:
Cardiology, S. Spirito Hospital, Rome, Italy. ab.scardovi@libero.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Anaerobic Threshold
Chronic Disease
Exercise Test* / adverse effects
Feasibility Studies
Female
Heart Failure / diagnosis*,  physiopathology
Humans
Male
Odds Ratio
Oxygen Consumption
Prognosis
Reproducibility of Results
Respiratory Function Tests*
Respiratory Mechanics
Risk Assessment
Severity of Illness Index
Stroke Volume
Ventricular Function, Left*

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


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