Cardiopulmonary Exercise Testing in Heart Failure

被引:334
作者
Malhotra, Rajeev [1 ]
Bakken, Kristian [2 ]
D'Elia, Emilia [3 ,4 ]
Lewis, Gregory D. [1 ,2 ]
机构
[1] Harvard Med Sch, Massachusetts Gen Hosp, Dept Med, Div Cardiol, Boston, MA USA
[2] Harvard Med Sch, Massachusetts Gen Hosp, Dept Med, Pulm & Crit Care Unit, Boston, MA USA
[3] Hosp Papa Giovanni XXIII, Cardiovasc Dept, Bergamo, Italy
[4] Univ Pavia, Pavia, Italy
关键词
cardiopulmonary exercise testing; exercise physiology; heart failure; oxygen uptake; ventilatory efficiency; PRESERVED EJECTION FRACTION; PEAK OXYGEN-CONSUMPTION; GAS-EXCHANGE; OSCILLATORY VENTILATION; CARDIAC RESYNCHRONIZATION; PROGNOSTIC IMPORTANCE; SUBMAXIMAL EXERCISE; AMBULATORY PATIENTS; CONTROLLED-TRIAL; EFFICIENCY;
D O I
10.1016/j.jchf.2016.03.022
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Exercise intolerance, indicated by dyspnea and fatigue during exertion, is a cardinal manifestation of heart failure (HF). Cardiopulmonary exercise testing (CPET) precisely defines maximum exercise capacity through measurement of peak oxygen uptake (VO2). Peak VO2 values have a critical role in informing patient selection for advanced HF interventions such as heart transplantation and ventricular assist devices. Oxygen uptake and ventilatory patterns obtained during the submaximal portion of CPET are also valuable to recognize because of their ease of ascertainment during low-level exercise, relevance to ability to perform activities of daily living, independence from volitional effort, and strong relationship to prognosis in HF. The ability of peak VO2 and other CPET variables to be measured reproducibly and to accurately reflect HF severity is increasingly recognized and endorsed by scientific statements. Integration of CPET with invasive hemodynamic monitoring and cardiac imaging during exercise provides comprehensive characterization of multisystem reserve capacity that can inform prognosis and the need for cardiac interventions. Here, we review both practical aspects of conducting CPETs in patients with HF for clinical and research purposes as well as interpretation of gas exchange patterns across the spectrum of preclinical HF to advanced HF. (C) 2016 by the American College of Cardiology Foundation.
引用
收藏
页码:607 / 616
页数:10
相关论文
共 66 条
[1]   Development of a ventilatory classification system in patients with heart failure [J].
Arena, Ross ;
Myers, Jonathan ;
Abella, Joshua ;
Peberdy, Mary Ann ;
Bensimhon, Daniel ;
Chase, Paul ;
Guazzi, Marco .
CIRCULATION, 2007, 115 (18) :2410-2417
[2]   Determining the Preferred Percent-Predicted Equation for Peak Oxygen Consumption in Patients With Heart Failure [J].
Arena, Ross ;
Myers, Jonathan ;
Abella, Joshua ;
Pinkstaff, Sherry ;
Brubaker, Peter ;
Moore, Brian ;
Kitzman, Dalane ;
Peberdy, Mary Ann ;
Bensimhon, Daniel ;
Chase, Paul ;
Forman, Daniel ;
West, Erin ;
Guazzi, Marco .
CIRCULATION-HEART FAILURE, 2009, 2 (02) :113-120
[3]   Dynamic regulation of circulating microRNA during acute exhaustive exercise and sustained aerobic exercise training [J].
Baggish, Aaron L. ;
Hale, Andrew ;
Weiner, Rory B. ;
Lewis, Gregory D. ;
Systrom, David ;
Wang, Francis ;
Wang, Thomas J. ;
Chan, Stephen Y. .
JOURNAL OF PHYSIOLOGY-LONDON, 2011, 589 (16) :3983-3994
[4]   Clinician's Guide to Cardiopulmonary Exercise Testing in Adults A Scientific Statement From the American Heart Association [J].
Balady, Gary J. ;
Arena, Ross ;
Sietsema, Kathy ;
Myers, Jonathan ;
Coke, Lola ;
Fletcher, Gerald F. ;
Forman, Daniel ;
Franklin, Barry ;
Guazzi, Marco ;
Gulati, Martha ;
Keteyian, Steven J. ;
Lavie, Carl J. ;
Macko, Richard ;
Mancini, Donna ;
Milani, Richard V. .
CIRCULATION, 2010, 122 (02) :191-225
[5]   Reproducibility of peak oxygen uptake and other cardiopulmonary exercise testing parameters in patients with heart failure (from the Heart Failure and A Controlled Trial Investigating Outcomes of exercise traiNing) [J].
Bensimhon, Daniel R. ;
Leifer, Eric S. ;
Ellis, Stephen J. ;
Fleg, Jerome L. ;
Keteyian, Steven J. ;
Pina, Ileana L. ;
Kitzman, Dalane W. ;
McKelvie, Robert S. ;
Kraus, William E. ;
Forman, Daniel E. ;
Kao, Andrew J. ;
Whellan, David J. ;
O'Connor, Christopher M. ;
Russell, Stuart D. .
AMERICAN JOURNAL OF CARDIOLOGY, 2008, 102 (06) :712-717
[6]   Prognostic significance of oxygen uptake kinetics during low level exercise in patients with heart failure [J].
Brunner-La Rocca, HP ;
Weilenmann, D ;
Schalcher, C ;
Schlumpf, M ;
Follath, F ;
Candinas, R ;
Kiowski, W .
AMERICAN JOURNAL OF CARDIOLOGY, 1999, 84 (06) :741-+
[7]   Prolonged Mean VO2 Response Time in Systolic Heart Failure An Indicator of Impaired Right Ventricular-Pulmonary Vascular Function [J].
Chatterjee, Neal A. ;
Murphy, Ryan M. ;
Malhotra, Rajeev ;
Dhakal, Bishnu P. ;
Baggish, Aaron L. ;
Pappagianopoulos, Paul P. ;
Hough, Stacyann S. ;
Semigran, Marc J. ;
Lewis, Gregory D. .
CIRCULATION-HEART FAILURE, 2013, 6 (03) :499-+
[8]   Exercise-Induced Myocardial Ischemia Detected by Cardiopulmonary Exercise Testing [J].
Chaudhry, Sundeep ;
Arena, Ross ;
Wasserman, Karlman ;
Hansen, James E. ;
Lewis, Gregory D. ;
Myers, Jonathan ;
Chronos, Nicolas ;
Baden, William E. .
AMERICAN JOURNAL OF CARDIOLOGY, 2009, 103 (05) :615-619
[9]  
Cheyne J, 1818, DUBLIN HOSP REP COMM, V1818, P216
[10]   Four-Variable Risk Model in Men and Women With Heart Failure [J].
Chyu, Jennifer ;
Fonarow, Gregg C. ;
Tseng, Chi Hong ;
Horwich, Tamara B. .
CIRCULATION-HEART FAILURE, 2014, 7 (01) :88-95