Aug 19, 2007

The prognostic value of cardiopulmonary exercise testing with a peak respiratory exchange ratio of <1.0 in patients with chronic heart failure

International Journal of Cardiology
Lee IngleAndrew L Clark


Peak oxygen consumption derived from a maximal cardiopulmonary exercise test (CPET) is a standard prognostic indicator in patients with chronic heart failure (CHF). Tests with a peak respiratory exchange ratio (pRER)<1.0 are often taken to be submaximal, and data from such tests are treated as less helpful. The aim of the current study was to compare the prognostic value of CPETs with a peak respiratory exchange ratio (pRER)<1.0 versus a pRER>/=1.0 in a large, representative sample of patients with CHF. 445 patients underwent a symptom-limited, treadmill-based CPET using the modified Bruce protocol, [82% males; age 72 (65-79) years]. 255 patients completed the CPET with a pRER>/=1.0. 121 patients died, and in survivors, the median follow-up period was 42 months. 42% of patients could not perform a CPET with pRER>/=1.0 using a modified Bruce protocol. Independent predictors of mortality were peak oxygen uptake, and the VE/VCO(2) ratio. 190 patients completed the CPET with a pRER<1.0. Independent predictors of mortality were age, peak oxygen pulse, and history of angina. RER group (pRER<1.0 versus pRER>/=1.0) remained an independent predictor of mortality in all patients. Independent predictors of mortality were different in pati...Continue Reading

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Mentioned in this Paper

Metabolic Process, Cellular
Chronic Heart Failure
Circulatory System
Degenerative Polyarthritis
Depressed - Symptom
Left Ventricular Function
Cardiopulmonary Exercise Test
Exercise Stress Test
Pulmonary Gas Exchange

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