Cardiorespiratory Fitness (Peak Oxygen Uptake): Safe and Effective Measure for Cardiovascular Screening Before Kidney Transplant

Journal of the American Heart Association
Harini A ChakkeraD Eric Steidley

Abstract

Significant heterogeneity exists in practice patterns and algorithms used for cardiac screening before kidney transplant. Cardiorespiratory fitness, as measured by peak oxygen uptake (VO2peak), is an established validated predictor of future cardiovascular morbidity and mortality in both healthy and diseased populations. The literature supports its use among asymptomatic patients in abrogating the need for further cardiac testing. We outlined a pre-renal transplant screening algorithm to incorporate VO2peak testing among a population of asymptomatic high-risk patients (with diabetes mellitus and/or >50 years of age). Only those with VO2peak <17 mL/kg per minute (equivalent to <5 metabolic equivalents) underwent further noninvasive cardiac screening tests. We conducted a retrospective study of the a priori dichotomization of the VO2peak <17 versus ≥17 mL/kg per minute to determine negative and positive predictive value of future cardiac events and all-cause mortality. We report a high (>90%) negative predictive value, indicating that VO2peak ≥17 mL/kg per minute is effective to rule out future cardiac events and all-cause mortality. However, lower VO2peak had low positive predictive value and should not be used as a reliable met...Continue Reading

References

Jul 29, 2008·American Heart Journal·Steven J KeteyianPhilip A Ades
Jun 18, 2011·Medicine and Science in Sports and Exercise·Barbara E AinsworthArthur S Leon
Jul 6, 2012·Journal of the American College of Cardiology·Krista L LentineUNKNOWN American Heart Association Council on the Kidney in Cardiovascular Disease and Council on Peripheral Vascular Disease
Jul 4, 2015·Circulation Research·Carl J LavieSteven N Blair
Mar 14, 2017·Progress in Cardiovascular Diseases·Matthew P HarberRobert Ross

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Citations

Mar 10, 2021·Aging Clinical and Experimental Research·Jonathan MyersRalph Rabkin
Apr 7, 2021·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Eva PellaPantelis Sarafidis

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coronary artery bypass

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