Use of the cardiopulmonary exercise test to evaluate the patient with chronic heart failure

J. S. Janicki, Karl Weber, P. A. McElroy

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Isotonic exercise testing imposes a physiological stress on the cardiopulmonary unit. Accordingly, monitoring of oxygen, carbon dioxide and air flow during an exercise test (i.e. a cardiopulmonary exercise test) can be used to assess heart function in patients with chronic heart failure. Specifically, an incremental treadmill cardiopulmonary exercise test represents a non-invasive means to determine aerobic capacity, or maximal oxygen uptake (V̇O(2max) ml min-1 kg-1), and anaerobic threshold (AT, ml min-1 kg-1). These objective measures of cardiopulmonary function are then used to grade the severity of failure and the functional capacity of the patient. In addition, they may be used to predict the cardiac reserve, or maximal cardiac index (CI(max), l min-1 m-2) during exercise. That is, the severity is considered to be mild (class A) when AT > 14 or V̇O(2max) > 20, mild to moderate (class B) when AT falls between 11 and 14 or V̇O(2max) between 16 and 20, moderate to severe (class C) when AT ranges between 8 and 11 or V̇O(2max) between 10 and 16, and severe (class D) when AT < 8 or V̇O(2max) < 10. The predicted CI(max) for classes A, B, C and D are >8, 6-8, 4-6 and <4, respectively. Finally, a major objective of medical therapy in patients with heart failure is to improve cardiac output and oxygen delivery to working skeletal muscle and thereby enhance effort tolerance. This therapeutic endpoint can be gauged by cardiopulmonary exercise testing from the response in AT and V̇O(2max).

Original languageEnglish (US)
Pages (from-to)55-58
Number of pages4
JournalEuropean Heart Journal
Volume9
Issue numberSUPPL. H
StatePublished - Jan 1 1988
Externally publishedYes

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Exercise Test
Heart Failure
Exercise
Oxygen
Anaerobic Threshold
Physiological Stress
Carbon Dioxide
Cardiac Output
Skeletal Muscle
Air
Therapeutics

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Use of the cardiopulmonary exercise test to evaluate the patient with chronic heart failure. / Janicki, J. S.; Weber, Karl; McElroy, P. A.

In: European Heart Journal, Vol. 9, No. SUPPL. H, 01.01.1988, p. 55-58.

Research output: Contribution to journalArticle

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