Data di Pubblicazione:
2023
Citazione:
Cardiopulmonary exercise testing and heart failure: a tale born from oxygen uptake / M. Mapelli, E. Salvioni, I. Mattavelli, C. Vignati, A. Galotta, D. Magrì, A. Apostolo, S. Sciomer, J. Campodonico, P. Agostoni. - In: EUROPEAN HEART JOURNAL SUPPLEMENTS. - ISSN 1554-2815. - 25:Supplement_C(2023), pp. 319-325. [10.1093/eurheartjsupp/suad057]
Abstract:
Since 50 years, cardiopulmonary exercise testing (CPET) plays a central role in heart
failure (HF) assessment. Oxygen uptake (VO 2) is one of the main HF prognostic indica-
tors, then paralleled by ventilation to carbon dioxide (VE/VCO 2) relationship slope.
Also anaerobic threshold retains a strong prognostic power in severe HF, especially if
expressed as a percent of maximal VO2 predicted value. Moving beyond its absolute va-
lue, a modern approach is to consider the percentage of predicted value for peak VO 2
and VE/VCO 2 slope, thus allowing a better comparison between genders, ages, and
races. Several VO2 equations have been adopted to predict peak VO2 , built considering
different populations. A step forward was made possible by the introduction of reliable
non-invasive methods able to calculate cardiac output during exercise: the inert gas
rebreathing method and the thoracic electrical bioimpedance. These techniques
made possible to calculate the artero-venous oxygen content differences (ΔC(a-v)
O2 ), a value related to haemoglobin concentration, pO 2, muscle perfusion, and oxygen
extraction. The role of haemoglobin, frequently neglected, is however essential being
anaemia a frequent HF comorbidity. Finally, peak VO2 is traditionally obtained in a la-
boratory setting while performing a standardized physical effort. Recently, different
wearable ergo-spirometers have been developed to allow an accurate metabolic
data collection during different activities that better reproduce HF patients’ everyday
life. The evaluation of exercise performance is now part of the holistic approach to the
HF syndrome, with the inclusion of CPET data into multiparametric prognostic scores,
such as the MECKI score.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Cardiac output; Cardiopulmonary exercise test; Heart failure prognosis; Oxygen uptake; Prognostic score
Elenco autori:
M. Mapelli, E. Salvioni, I. Mattavelli, C. Vignati, A. Galotta, D. Magrì, A. Apostolo, S. Sciomer, J. Campodonico, P. Agostoni
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