Does reduced cardiopulmonary exercise testing performance predict poorer quality of life in adult patients with Fontan physiology?

2020 ◽  
pp. 1-7
Author(s):  
Blair Suter ◽  
William A. Kay ◽  
Alisha M. Kuhlenhoelter ◽  
Eric S. Ebenroth
Keyword(s):  
Quality Of Life ◽  
Exercise Testing ◽  
Exercise Performance ◽  
School Quality ◽  
Cardiopulmonary Exercise Testing ◽  
Cardiopulmonary Exercise ◽  
Testing Performance ◽  
Fontan Physiology

Abstract Background: Cardiopulmonary exercise testing performance has been shown to be a predictor of morbidity, mortality, and quality of life in patients with Fontan physiology; however, the role of exercise performance along with other diagnostics is not fully understood. We evaluated the hypothesis that reduced exercise performance correlates with poorer quality of life in Fontan patients as they continue to age. Methods: Chart review was performed on patients 12 years and older with Fontan who had completed cardiopulmonary exercise testing and age-appropriate quality of life surveys. Quality of life outcomes were analysed against exercise performance and other descriptive data. Results: For the younger cohort (n = 22), exercise performance predicted quality of life with different measures across domains and had a stronger correlation than echocardiographic parameters. For the older cohort (n = 34), exercise performance did not predict quality of life. Conclusions: Objective exercise performance was a useful marker for general, physical, emotional, social, and school quality of life in a younger cohort but less helpful in older adults. This is perhaps due to older patients accommodating to their conditions over time. The role of exercise performance and objective data in predicting quality of life in patients with Fontan physiology is incompletely understood and additional prospective evaluation should be undertaken.

scholarly journals Correlation of cardiopulmonary exercise testing parameters with quality of life in stable COPD patients

2016 ◽  
Vol 8 (8) ◽  
pp. 2138-2145 ◽  
Author(s):  
Mahsa Mirdamadi ◽  
Besharat Rahimi ◽  
Enayat Safavi ◽  
Hamidreza Abtahi ◽  
Soheil Peiman
Keyword(s):  
Quality Of Life ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Cardiopulmonary Exercise ◽  
Copd Patients

Cardiac rehabilitation in patients with refractory angina trial: rationale and design (Preprint)

2019 ◽  
Author(s):  
Luciana Dourado ◽  
Camila Jordão ◽  
Camila Regina Assumpção ◽  
Carla Montenegro ◽  
Luis Henrique Gowdak ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cardiac Rehabilitation ◽  
Exercise Testing ◽  
Controlled Trial ◽  
Cardiopulmonary Exercise Testing ◽  
Refractory Angina ◽  
Target Heart Rate ◽  
Beneficial Effects ◽  
Cardiopulmonary Exercise

BACKGROUND Refractory angina is a chronic condition that implies significant impairment in quality of life; its management is a challenge. Current therapies are limited, and new approaches to treatment are needed that target symptoms and quality of life. Evidence is lacking regarding exercise-based cardiac rehabilitation safety and beneficial effects in patients with refractory angina. OBJECTIVE The aim of the present study is to evaluate the safety and feasibility of exercise-based cardiac rehabilitation in patients with refractory angina, and its effects on angina symptoms, functional capacity, and ischemic burden. METHODS This study is an ongoing prospective randomized controlled trial enrolling 52 patients with refractory angina randomized into 2 groups: optimal medical treatment (MT) or MT + exercise-based cardiac rehabilitation (CR) over 12 weeks (36 exercise sessions). Clinical evaluation, cardiopulmonary exercise testing, laboratory tests, and exercise echocardiography are performed before and after intervention. The CR group performs in-hospital exercise sessions. The aerobic training protocol is based on CPT parameters or ischemia/angina threshold. Each cardiac rehabilitation session is 60 minutes long (5 minutes of warm-up, 30 minutes of continuous aerobic exercise based on target heart rate corresponding to anaerobic threshold (AT) obtained in the cardiopulmonary exercise testing OR angina/ischemia threshold if it occurs before the AT, 5 minutes of cooling-down, 15 minutes of resistance training, and 5 minutes of stretching). RESULTS This research study is in progress, with 42 patients recruited as of August 2019. Data collection is expected to be finished before December 2020. No clinical adverse events related to CR have occurred. CONCLUSIONS The findings of this study will have important clinical implications in the treatment of refractory angina patients. CLINICALTRIAL NCT03218891

Risk stratification in hf with mid-range LVEF: the role of cardiopulmonary exercise testing

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
B.M.L Rocha ◽  
G.J Lopes Da Cunha ◽  
P.M.D Lopes ◽  
P.N Freitas ◽  
F Gama ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Exercise Testing ◽  
Primary Endpoint ◽  
Prognostic Significance ◽  
Cardiopulmonary Exercise Testing ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Cardiopulmonary Exercise

Abstract Background Cardiopulmonary exercise testing (CPET) is recommended in the evaluation of selected patients with Heart Failure (HF). Notwithstanding, its prognostic significance has mainly been ascertained in those with left ventricular ejection fraction (LVEF) <40% (i.e., HFrEF). The main goal of our study was to assess the role of CPET in risk stratification of HF with mid-range (40–49%) LVEF (i.e., HFmrEF) compared to HFrEF. Methods We conducted a single-center retrospective study of consecutive patients with HF and LVEF <50% who underwent CPET from 2003–2018. The primary composite endpoint of death, heart transplant or HF hospitalization was assessed. Results Overall, 404 HF patients (mean age 57±11 years, 78.2% male, 55.4% ischemic HF) were included, of whom 321 (79.5%) had HFrEF and 83 (20.5%) HFmrEF. Compared to the former, those with HFmrEF had a significantly higher mean peak oxygen uptake (pVO2) (20.2±6.1 vs 16.1±5.0 mL/kg/min; p<0.001), lower median minute ventilation/carbon dioxide production (VE/VCO2) [35.0 (IQR: 29.1–41.2) vs 39.0 (IQR: 32.0–47.0); p=0.002) and fewer patients with exercise oscillatory ventilation (EOV) (22.0 vs 46.3%; p<0.001). Over a median follow-up of 28.7 (IQR: 13.0–92.3) months, 117 (28.9%) patients died, 53 (13.1%) underwent heart transplantation, and 134 (33.2%) had at least one HF hospitalization. In both HFmrEF and HFrEF, pVO2 <12 mL/kg/min, VE/VCO2 >35 and EOV identified patients at higher risk for events (all p<0.05). In Cox regression multivariate analysis, pVO2 was predictive of the primary endpoint in both HFmrEF and HFrEF (HR per +1 mL/kg/min: 0.81; CI: 0.72–0.92; p=0.001; and HR per +1 mL/kg/min: 0.92; CI: 0.87–0.97; p=0.004), as was EOV (HR: 4.79; CI: 1.41–16.39; p=0.012; and HR: 2.15; CI: 1.51–3.07; p<0.001). VE/VCO2, on the other hand, was predictive of events in HFrEF but not in HFmrEF (HR per unit: 1.03; CI: 1.02–1.05; p<0.001; and HR per unit: 0.99; CI: 0.95–1.03; p=0.512, respectively). ROC curve analysis demonstrated that a pVO2 >16.7 and >15.8 mL/kg/min more accurately identified patients at lower risk for the primary endpoint (NPV: 91.2 and 60.5% for HFmrEF and HFrEF, respectively; both p<0.001). Conclusions CPET is a useful tool in HFmrEF. Both pVO2 and EOV independently predicted the primary endpoint in HFmrEF and HFrEF, contrasting with VE/VCO2, which remained predictive only in latter group. Our findings strengthen the prognostic role of CPET in HF with either reduced or mid-range LVEF. Funding Acknowledgement Type of funding source: None

scholarly journals Pulmonary Capillary Hemangiomatosis: The Role of Invasive Cardiopulmonary Exercise Testing

2015 ◽  
Vol 5 (3) ◽  
pp. 580-586 ◽  
Author(s):  
Hilary M. DuBrock ◽  
Richard L. Kradin ◽  
Josanna M. Rodriguez-Lopez ◽  
Richard N. Channick
Keyword(s):  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Cardiopulmonary Exercise ◽  
Pulmonary Capillary ◽  
Pulmonary Capillary Hemangiomatosis
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