Twenty years ago, the seminal study led by Donna Mancini demonstrating the prognostic value of cardiopulmonary exercise testing (CPX) in heart failure (HF) was published. This study assessed the ability of peak oxygen consumption (VO2) to reflect mortality risk in a cohort consisting of 114 patients with HF. The impact of these initial findings influenced clinical practice patterns for more than a decade in that peak VO2 was commonly the only CPX variable considered for risk stratification. Over the last 20 years, a large body of data demonstrating the prognostic importance of other CPX variables has come to fruition. The additional CPX measures highly relevant to the HF population include indices of ventilatory efficiency (i.e. the VEIVCO2 slope, the partial pressure of end-tidal carbon dioxide and exercise oscillatory ventilation), heart rate, electrocardiographic and other hemodynamic responses, and symptomatology. In the scientific community committed to the study of CPX in HF, it is currently well-recognized that a multivariate approach should be applied for optimal prognostic assessment. The clinical community responsible for the management of the HF population has begun to embrace this approach. This review describes the 20 year evolution of CPX in the HF population.
|Translated title of the contribution||The evolution of the prognostic value of CPX in patients with heart failure|
|Number of pages||4|
|Publication status||Published - Mar 2013|
- Adverse events
- Exercise testing
- Multivariate model
ASJC Scopus subject areas