Data di Pubblicazione:
2023
Citazione:
Beyond VO2: the complex cardiopulmonary exercise test / I. Mattavelli, C. Vignati, P. Agostoni, G. Cattadori. - In: EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY. - ISSN 2047-4873. - (2023). [Epub ahead of print] [10.1093/eurjpc/zwad154]
Abstract:
Cardiopulmonary exercise test (CPET) is a valuable diagnostic tool with a specific
application in heart failure (HF) thanks to the strong prognostic value of its parameters.
The most important value provided by CPET is the peak oxygen uptake (peak VO2),
the maximum rate of oxygen consumption attainable during physical exertion.
According to the Fick principle, VO2 equals cardiac output (Qc) times the arteriovenous
content difference [C(a–v)O2], where Ca is the arterial oxygen and Cv is the mixed
venous oxygen content, respectively; therefore, VO2 can be reduced both by impaired
O2 delivery (reduced Qc) or extraction (reduced arteriovenous O2 content).
However, standard CPET is not capable of discriminating between these different
impairments, leading to the need for “complex” CPET technologies. Among noninvasive
methods for Qc measurement during CPET, inert gas rebreathing and thoracic
impedance cardiography are the most used techniques, both validated in healthy
subjects and patients with HF, at rest and during exercise. On the other hand, the noninvasive
assessment of peripheral muscle perfusion is possible with the application of
near infra-red spectroscopy, capable of measuring tissue oxygenation.
Measuring Qc allows, by having hemoglobin values available, to discriminate how
much any VO2 deficit depends on muscle, anemia or heart.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Heart failure; complex cardiopulmonary exercise test; cardiac output measurement;
Elenco autori:
I. Mattavelli, C. Vignati, P. Agostoni, G. Cattadori
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