Peak exercise cardiac output but not oxygen uptake increases in all heart failure patients after successful resynchronization therapy
Articolo
Data di Pubblicazione:
2020
Citazione:
Peak exercise cardiac output but not oxygen uptake increases in all heart failure patients after successful resynchronization therapy / G. Cattadori, C. Vignati, A. Bonomi, M. Mapelli, S. Sciomer, M. Pepi, C. Tondo, G. Ambrosio, S. Di Marco, M. Baravelli, P. Agostoni. - In: CARDIOLOGY AND CARDIOVASCULAR MEDICINE. - ISSN 2572-9292. - 4:4(2020 Aug 03), pp. 386-395. [10.26502/fccm.92920135]
Abstract:
Objectives and Background: Hemodynamic changes at rest and during exercise in heart failure (HF) after cardiac resynchronization therapy (CRT) are still undefined.
Methods: In 93 HF patients, before and 8 ± 3 months after CRT, we assessed clinical conditions, ECG and standard echocardiography and we performed a maximal cardiopulmonary exercise test with non-invasive measurement of cardiac output (CO) by inert gas rebreathing method.
Results: At rest, CRT shortened QRS and improved NYHA class and left ventricular ejection fraction (LVEF), but not CO and stroke volume (SV). On average, at peak exercise, a significant improvement of oxygen uptake (VO2) (from 13.8 ± 3.8 ml/min/kg to 14.9 ± 4.6, p<0.0025), CO (from 6.19 ± 1.82 L/min to 6.97 ± 2.21, p<0.0001), and SV (from 62 ± 18 mL to 71 ± 19, p<0.0001) were detected. Regardless of HF severity, after CRT, patients showed a significant peak SV and CO increase, but a significant peak VO2 increase was observed only in patients with the lowest pre-CRT peak VO2 (5.9-11.3 ml/kg/min).
Conclusions: Our data showed that: a) SV at rest was not affected by CRT, regardless of LVEF improvement; b) post-CRT peak VO2 improvement was limited to HF patients with low pre-CRT peak VO2; c) post-CRT, a similar peak CO increase was observed regardless of pre-CRT peak VO2. Consequently, the assessment of peak CO is preferable to analyze CRT effects on exercise.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
cardiac resynchronization therapy; heart failure; cardiac output
Elenco autori:
G. Cattadori, C. Vignati, A. Bonomi, M. Mapelli, S. Sciomer, M. Pepi, C. Tondo, G. Ambrosio, S. Di Marco, M. Baravelli, P. Agostoni
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