A new cardiopulmonary exercise testing prognosticating algorithm for heart failure patients treated with beta-blockers

Eur J Prev Cardiol. 2012 Apr;19(2):185-91. doi: 10.1177/1741826710396625. Epub 2011 Mar 4.

Abstract

In 2004, a cardiopulmonary exercise testing (CPET) prognosticating algorithm for heart failure (HF) patients was proposed. The algorithm employed a stepwise assessment of peak oxygen consumption (VO2), slope of regression relating minute ventilation to carbon dioxide output (VE/VCO2) and peak respiratory exchange ratio (RER), and was proposed as an alternative to the traditional strategy of using a single CPET parameter to describe prognosis. Since its initial proposal, the prognosticating algorithm has not been reassessed, although a re-evaluation is in order given the fact that new HF therapies, such as beta-blocker therapy, have significantly improved survival in HF. The present review, based on a critical examination of CPET outcome studies in HF patients regularly treated with beta-blockers, suggests a new prognosticating algorithm. The algorithm comprises four CPET parameters: peak RER, exertional oscillatory ventilation (EOV), peak VO2 and peak systolic blood pressure (SBP). Compared to previous proposals, the present preliminary attempt includes EOV instead of VE/VCO2 slope as ventilatory CPET parameter, and peak SBP as hemodynamic-derived index.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / pharmacology
  • Adrenergic beta-Antagonists / therapeutic use*
  • Algorithms*
  • Carbon Dioxide / metabolism
  • Exercise Test / methods*
  • Exercise Tolerance / drug effects*
  • Heart Failure / diagnosis
  • Heart Failure / drug therapy*
  • Heart Failure / physiopathology
  • Humans
  • Oxygen Consumption
  • Prognosis
  • ROC Curve

Substances

  • Adrenergic beta-Antagonists
  • Carbon Dioxide