scholarly journals H2FPEF Score for the Prediction of Exercise Intolerance and Abnormal Hemodynamics in Japanese　― Evaluation by Exercise Stress Echocardiography Combined With Cardiopulmonary Exercise Testing ―

2019 ◽  
Vol 83 (12) ◽  
pp. 2487-2493 ◽  
Author(s):  
Kosuke Takahari ◽  
Takayuki Hidaka ◽  
Yusuke Ueda ◽  
Kanako Izumi ◽  
Yu Harada ◽  
...  
Keyword(s):  
Exercise Testing ◽  
Stress Echocardiography ◽  
Cardiopulmonary Exercise Testing ◽  
Exercise Stress ◽  
Exercise Intolerance ◽  
Cardiopulmonary Exercise ◽  
Exercise Stress Echocardiography

scholarly journals P942 Outcome prediction by exercise stress echocardiography and cardiopulmonary exercise testing assessment in patients with heart failure

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
K Sakata ◽  
H Mitsuda ◽  
J Ito ◽  
A Isaka ◽  
A Gouda ◽  
...  
Keyword(s):  
Heart Failure ◽  
Exercise Testing ◽  
Cardiac Dysfunction ◽  
Stress Echocardiography ◽  
Cardiopulmonary Exercise Testing ◽  
Exercise Stress ◽  
Cardiac Resynchronization ◽  
Cardiopulmonary Exercise ◽  
Peak Vo2 ◽  
Patients With Heart Failure

Abstract Background Cardiopulmonary exercise testing (CPX) is essential to the assessment of functional impairment and prognosis in patients with heart failure (HF). Peak oxygen consumption (peak VO2) continues to be considered the gold standard for assessing prognosis in HF. The minute ventilation-carbon dioxide production (VE-VCO2) slope has recently demonstrated prognostic significance in patients with HF. Ergometer stress echocardiography (Erg-Echo) is useful to evaluate the exercise-induced pulmonary hypertension and the potential cardiac dysfunction that are difficult to evaluate in the resting state. Objective The aim of this study is to evaluate the relationship between CPX and Erg-echo indices, and the usefulness of Erg-echo to determine the severity of cardiac dysfunction and the prognosis in patients with HF. Methods We studied 58 patients with HF (age 65.2 ± 11.9 years) and performed CPX and Erg-Echo. The peak VO2 and the VE-VCO2 slope were measured by CPX. Cardiac output (CO) and estimated mean pulmonary artery pressure (mPAP) were measured by Erg-Echo at rest and peak exercise load, and the change ratio (ΔmPAP / ΔCO) were calculated. We evaluated the clinical outcome during a1 year period. Results The ΔmPAP / ΔCO was significantly correlated with the peak VO2 (R = -0.6767, P <0.0001) and the VE-VCO2 slope (R = 0.6809, P <0.0001). Cardiovascular events (1 patient of cardiovascular death, 8 patients of re-hospitalization due to HF, 4 patients of myocardial ischemia, 2 patients of Cardiac Resynchronization Therapy (CRT) devices implantation, 1 patient of ventricular tachycardia) developed in 16 of the 58 patients (27.5%: Group CE) during the 1 year. The peak VO2 was significantly lower (12.1 ± 2.5 vs. 16.1 ± 3.1ml/min/kg, P <0.0001) and the VE-VCO2 slope was significantly higher (41.1 ±. 12.3 vs. 31.8 ± 6.1ml/ml, P <0.0001) in Group CE compared to the other 42 patients (Group N). The ΔmPAP was significantly higher (19.1 ± 4.4 vs. 14.9 ± 6.4, P = 0.0408) and the ΔCO was significantly lower (2.4 ± 1.2 vs. 4.1 ± 2.0, P = 0.0078), and the ΔmPAP / ΔCO was significantly higher (9.7 ± 4.6 vs. 4.4 ± 2.4, P <0.0001) in Group CE compared to Group N. Conclusions The ΔmPAP/ ΔCO by Erg-Echo is useful to evaluate the severity of cardiac dysfunction and the prognosis of HF patients.

scholarly journals Cardiopulmonary exercise testing (CPET) in patients with end-stage kidney disease (ESKD): principles, methodology and clinical applications of the optimal tool for exercise tolerance evaluation

2021 ◽  
Author(s):  
Eva Pella ◽  
Afroditi Boutou ◽  
Aristi Boulmpou ◽  
Christodoulos E Papadopoulos ◽  
Aikaterini Papagianni ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Exercise Intolerance ◽  
End Stage Kidney Disease ◽  
Exercise Limitation ◽  
Cardiopulmonary Exercise ◽  
Functional Reserves ◽  
Increased Risk ◽  
End Stage

Abstract Chronic kidney disease (CKD), especially end-stage kidney disease (ESKD), is associated with increased risk for cardiovascular events and all-cause mortality. Exercise intolerance as well as reduced cardiovascular reserve are extremely common in patients with CKD. Cardiopulmonary exercise testing (CPET) is a non-invasive, dynamic technique that provides an integrative evaluation of cardiovascular, pulmonary, neuropsychological and metabolic function during maximal or submaximal exercise, allowing the evaluation of functional reserves of these systems. This assessment is based on the principle that system failure typically occurs when the system is under stress and, thus, CPET is currently considered to be the gold-standard for identifying exercise limitation and differentiating its causes. It has been widely used in several medical fields for risk stratification, clinical evaluation and other applications but its use in everyday practice for CKD patients is scarce. This article describes the basic principles and methodology of CPET and provides an overview of important studies that utilized CPET in patients with ESKD, in an effort to increase awareness of CPET capabilities among practicing nephrologists.

Reproducibility of Inert Gas Rebreathing Method to Estimate Cardiac Output at Rest and During Cardiopulmonary Exercise Stress Testing

2019 ◽  
Vol 40 (02) ◽  
pp. 125-132 ◽  
Author(s):  
Nduka Okwose ◽  
Jie Zhang ◽  
Shakir Chowdhury ◽  
David Houghton ◽  
Srdjan Ninkovic ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Exercise Testing ◽  
Coefficient Of Variation ◽  
Cardiopulmonary Exercise Testing ◽  
Exercise Stress ◽  
Inert Gas ◽  
Peak Exercise ◽  
Cardiopulmonary Exercise ◽  
Inert Gas Rebreathing ◽  
Rebreathing Method

AbstractThe present study evaluated reproducibility of the inert gas rebreathing method to estimate cardiac output at rest and during cardiopulmonary exercise testing. Thirteen healthy subjects (10 males, 3 females, ages 23–32 years) performed maximal graded cardiopulmonary exercise stress test using a cycle ergometer on 2 occasions (Test 1 and Test 2). Participants cycled at 30-watts/3-min increments until peak exercise. Hemodynamic variables were assessed at rest and during different exercise intensities (i. e., 60, 120, 150, 180 watts) using an inert gas rebreathing technique. Cardiac output and stroke volume were not significantly different between the 2 tests at rest 7.4 (1.6) vs. 7.1 (1.2) liters min−1, p=0.54; 114 (28) vs. 108 (15) ml beat−1, p=0.63) and all stages of exercise. There was a significant positive relationship between Test 1 and Test 2 cardiac outputs when data obtained at rest and during exercise were combined (r=0.95, p<0.01 with coefficient of variation of 6.0%), at rest (r=0.90, p<0.01 with coefficient of variation of 5.1%), and during exercise (r=0.89, p<0.01 with coefficient of variation 3.3%). The mean difference and upper and lower limits of agreement between repeated measures of cardiac output at rest and peak exercise were 0.4 (−1.1 to 1.8) liter min−1 and 0.5 (−2.3 to 3.3) liter min−1, respectively. The inert gas rebreathing method demonstrates an acceptable level of test-retest reproducibility for estimating cardiac output at rest and during cardiopulmonary exercise testing at higher metabolic demands.

scholarly journals Combined use of stress echocardiography and cardiopulmonary exercise testing to assess exercise intolerance in patients treated for acute myocardial infarction

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255682
Author(s):  
Krzysztof Smarz ◽  
Tomasz Jaxa-Chamiec ◽  
Beata Zaborska ◽  
Maciej Tysarowski ◽  
Andrzej Budaj
Keyword(s):  
Heart Rate ◽  
Stroke Volume ◽  
Stress Echocardiography ◽  
Cardiopulmonary Exercise Testing ◽  
Exercise Intolerance ◽  
Cardiopulmonary Exercise ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Exercise intolerance after acute myocardial infarction (AMI) is a predictor of worse prognosis, but its causes are complex and poorly studied. This study assessed the determinants of exercise intolerance using combined stress echocardiography and cardiopulmonary exercise testing (CPET-SE) in patients treated for AMI. We prospectively enrolled patients with left ventricular ejection fraction (LV EF) ≥40% for more than 4 weeks after the first AMI. Stroke volume, heart rate, and arteriovenous oxygen difference (A-VO2Diff) were assessed during symptom-limited CPET-SE. Patients were divided into four groups according to the percentage of predicted oxygen uptake (VO2) (Group 1, <50%; Group 2, 50–74%; Group 3, 75–99%; and Group 4, ≥100%). Among 81 patients (70% male, mean age 58 ± 11 years, 47% ST-segment elevation AMI) mean peak VO2 was 19.5 ± 5.4 mL/kg/min. A better exercise capacity was related to a higher percent predicted heart rate (Group 2 vs. Group 4, p <0.01), higher peak A-VO2Diff (Group 1 vs. Group 3, p <0.01) but without differences in stroke volume. Peak VO2 and percent predicted VO2 had a significant positive correlation with percent predicted heart rate at peak exercise (r = 0.28, p = 0.01 and r = 0.46, p < 0.001) and peak A-VO2Diff (r = 0.68, p <0.001 and r = 0.36, p = 0.001) but not with peak stroke volume. Exercise capacity in patients treated for AMI with LV EF ≥40% is related to heart rate response during exercise and peak peripheral oxygen extraction. CPET-SE enables non-invasive assessment of the mechanisms of exercise intolerance.

Sign in / Sign up

Export Citation Format

Share Document