Document Detail


The role of exercise testing and gas-exchange measurement in the prognostic assessment of patients with heart failure.
MedLine Citation:
PMID:  9649936     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Functional impairment has long been recognized as an important factor in the risk paradigm among patients with heart disease. In chronic heart failure, this issue has been even more important in recent years because of the steady growth in the number of patients awaiting heart transplantation relative to the available pool of donor hearts. The use of gas-exchange techniques to assess patients with heart failure has attracted interest because these techniques provide a more precise, reproducible, objective, and physiologic expression of exercise tolerance. Numerous studies published in the 1990s demonstrate that maximal oxygen uptake (peak VO2) is an independent predictor of mortality in patients with heart failure. Achievement of a peak VO2 that is less than 14 mL/kg/min has been recognized as one of the relative indications for transplantation, because patients who achieve a measurement that is higher than 14 mL/kg/min have a 1-year mortality rate similar to that of patients who undergo transplantation (i.e., > 90%). However, some debate exists regarding the optimal cutpoint that separates survivors from nonsurvivors, and studies have not consistently defined the timing of the test relative to optimization of medical therapy. It has also been debated which hemodynamic variables, at rest or during exercise, should be used in combination with peak VO2 to optimally stratify risk in these patients. This article reviews the applications of cardiopulmonary exercise testing in prognosis among patients with chronic heart failure.
Authors:
J Myers; L Gullestad
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in cardiology     Volume:  13     ISSN:  0268-4705     ISO Abbreviation:  Curr. Opin. Cardiol.     Publication Date:  1998 May 
Date Detail:
Created Date:  1998-09-28     Completed Date:  1998-09-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8608087     Medline TA:  Curr Opin Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  145-55     Citation Subset:  IM    
Affiliation:
Palo Alto VA Health Care System, Cardiology, CA 94304, USA.
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MeSH Terms
Descriptor/Qualifier:
Chronic Disease
Exercise Test*
Follow-Up Studies
Heart Failure / diagnosis*,  mortality,  physiopathology
Heart Transplantation / physiology
Hemodynamics / physiology
Humans
Oxygen / blood
Prognosis
Pulmonary Gas Exchange / physiology*
Survival Rate
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

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


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