Seismocardiography Can Assess Cardiopulmonary Exercise Test Parameters in Patients with Heart Failure

BACKGROUND Chronic heart failure is characterized by an inability of the heart to pump enough blood to meet the demands of the body, resulting in the hallmark symptom of exercise intolerance. Chronic underperfusion of the peripheral tissues and impaired nitric oxide bioavailability have been implicated as contributors to the decrease in exercise capacity in these patients. nitric oxide bioavailability has been identified as an important mediator of exercise tolerance in healthy individuals, but there are limited studies examining the effects in patients with chronic heart failure. OBJECTIVE The proposed trial is designed to determine the effects of chronic inorganic nitrate supplementation on exercise tolerance in both patients with heart failure preserved ejection fraction (HFpEF) and heart failure reduced ejection fraction (HFrEF) and to determine whether there are any differential responses between the 2 cohorts. A secondary objective is to provide mechanistic insights into the 2 heart failure groups’ exercise responses to the nitrate supplementation. METHODS Patients with chronic heart failure (15=HFpEF and 15=HFrEF) aged 40 to 85 years will be recruited. Following an initial screen cardiopulmonary exercise test, participants will be randomly allocated in a double-blind fashion to consume either a nitrate-rich beetroot juice (16 mmol nitrate/day) or a nitrate-depleted placebo (for 5 days). Participants will continue daily dosing until the completion of the 4 testing visits (maximal cardiopulmonary exercise test, submaximal exercise test with echocardiography, vascular function assessment, and vastus lateralis muscle biopsy). There will then be a 2-week washout period after which the participants will cross over to the other treatment and complete the same 4 testing visits. RESULTS This study is funded by National Heart Foundation of Australia and Victoria University. Enrolment has commenced and the data collection is expected to be completed in mid 2018. The initial results are expected to be submitted for publication by the end of 2018. CONCLUSIONS If inorganic nitrate supplementation can improve exercise tolerance in patients with chronic heart failure, it has the potential to aid in further refining the treatment of patients in this population. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12615000906550; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368912 (Archived by WebCite at http://www.webcitation.org/6xymLMiFK)

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Elevated Neutrophil-Lymphocyte Ratio is Associated with a Poorer Cardiopulmonary Exercise Test Performance in Patients with Heart Failure

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2019.07.058 ◽

2019 ◽

Vol 25 (8) ◽

pp. S20

Author(s):

Rani Kuttab ◽

Joronia Chery ◽

Katelyn Carr ◽

Amanda R. Vest

Keyword(s):

Heart Failure ◽

Exercise Test ◽

Test Performance ◽

Cardiopulmonary Exercise Test ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Cardiopulmonary Exercise ◽

Patients With Heart Failure

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Prognostic power of anaerobic threshold parameters in patients with transposition of the great arteries and systemic right ventricle

Cardiology in the Young ◽

10.1017/s1047951119002361 ◽

2019 ◽

Vol 29 (12) ◽

pp. 1445-1451

Author(s):

António V. Gonçalves ◽

Tânia Mano ◽

Ana Agapito ◽

Sílvia A. Rosa ◽

Lídia de Sousa ◽

...

Keyword(s):

Heart Failure ◽

Heart Rate ◽

Right Ventricle ◽

Anaerobic Threshold ◽

Exercise Test ◽

Area Under The Curve ◽

Systemic Circulation ◽

Cardiopulmonary Exercise Test ◽

Cardiopulmonary Exercise ◽

Test Parameters

AbstractIntroduction:Both transposition of the great arteries (TGA) previously submitted to a Senning/Mustard procedure and congenitally corrected TGA (cc-TGA) have the systemic circulation supported by the morphological right ventricle, thereby rendering these patients to heart failure events risk. The aim of this study was to evaluate cardiopulmonary exercise test parameters for stratifying the risk of heart failure events in TGA patients.Methods:Retrospective evaluation of adult TGA patients with systemic circulation supported by the morphological right ventricle submitted to cardiopulmonary exercise test in a tertiary centre. Patients were followed up for at least 1 year for the primary endpoint of cardiac death or heart failure hospitalisation. Several cardiopulmonary exercise test parameters were analysed as potential predictors of the combined endpoint and their predictive power were compared (area under the curve).Results:Cardiopulmonary exercise test was performed in 44 TGA patients (8 cc-TGA), with a mean age of 35.1 ± 8.4 years. The primary endpoint was reached by 10 (22.7%) patients, with a mean follow-up of 36.7 ± 26.8 months. Heart rate at anaerobic threshold had the highest area under the curve value (0.864), followed by peak oxygen consumption (pVO2) (0.838). Heart rate at anaerobic threshold ≤95 bpm and pVO2 ≤20 ml/kg/min had a sensitivity of 87.5 and 80.0% and a specificity of 82.4 and 76.5%, respectively, for the primary outcome.Conclusion:Heart rate at anaerobic threshold ≤95 bpm had the highest predictive power of all cardiopulmonary exercise test parameters analysed for heart failure events in TGA patients with systemic circulation supported by the morphological right ventricle.

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