scholarly journals Correlation of the peak oxygen consumption and ventilatory aerobic threshold by cardiopulmonary exercise testing with atrial fibrillation recurrences after ablation in patients with paroxysmal atrial fibrillation

2020 ◽  
Vol 36 (3) ◽  
pp. 456-463
Author(s):  
Daiki Yamashita ◽  
Shigeshi Kamikawa ◽  
Ryou Tanaka ◽  
Natsumi Tabita ◽  
Saori Nishimura ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Oxygen Consumption ◽  
Exercise Testing ◽  
Paroxysmal Atrial Fibrillation ◽  
Cardiopulmonary Exercise Testing ◽  
Peak Oxygen Consumption ◽  
Aerobic Threshold ◽  
Cardiopulmonary Exercise

Abstract 17232: Cardiopulmonary Exercise Testing in Diabetic Chronic Heart Failure Patients With Microalbuminuria

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Thida tabucanon ◽  
Timothy Engelman ◽  
Sanjeeb S Bhattacharya ◽  
J Emanuel Finet ◽  
Wai Hong W Tang
Keyword(s):  
Oxygen Consumption ◽  
Exercise Testing ◽  
Beta Blocker ◽  
Multivariable Analysis ◽  
Cardiopulmonary Exercise Testing ◽  
Left Ventricular ◽  
Peak Oxygen Consumption ◽  
Left Ventricular Ejection ◽  
Cardiopulmonary Exercise ◽  
History Of

Introduction: Microalbuminuria can be a presentation of microvascular complication in diabetes mellitus (DM). Hypothesis: Microalbuminuria is associated with impaired exercise performance in chronic HF with DM patients. Methods: We retrospectively analyzed a cardiopulmonary exercise testing (CPET) database in 255 chronic HF patients with DM that had urine microalbumin test between December 2012 and September 2019. Demographic data and CPET parameters were compared between the patients who had and had not microalbuminuria which was defined by microalbumin/creatinine ratio ≥ 30 mg/g. Peak oxygen consumption (peak VO 2 ) ≤ 14 ml/kg/min and ≤ 12 ml/kg/min if had history of beta-blocker uses were classified as low peak VO 2 and used in multivariable analysis. Results: There were a total 92 patients (36.1%) that had microalbuminuria. Mean age was not significant different between the patients with and without microalbuminuria (57.7 vs 59.4 years, p = 0.26). The patients with microalbuminuria had lower body mass index (BMI; 30.8 vs. 32.7 kg/m 2 , p = 0.014) and had more history of beta-blocker (BB) uses (81.5% vs. 69.3%, p = 0.038), no significant different in other medication uses. Left ventricular ejection fraction (LVEF) was significant lower in patients with microalbuminuria (35.8% vs. 41.5%, p = 0.028). The patients with microalbuminuria had significant higher prevalence of low peak VO 2 (45.7% vs. 30.1%, p = 0.015) and lower peak stroke work (VO 2 /HR; 11.5 vs. 12.8 ml/ beat, p = 0.008). No significant different in ventricular efficiency slope (VE/VCO 2 ; 37.1 vs. 35.4, p = 0.094), Multivariable analysis showed that proteinuria was independently associated with low peak VO 2 after adjusted for age, sex, BMI LVEF, history of BB uses, VE/VCO 2 and HR at peak VO 2 , (odds ratio = 3.83, p < 0.001). Conclusions: Microalbuminuria was independently associated with low peak oxygen consumption in chronic HF with DM patients.

scholarly journals The Role of Cardiopulmonary Exercise Test in IPF Prognosis

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Christina Triantafillidou ◽  
Effrosyni Manali ◽  
Panagiotis Lyberopoulos ◽  
Likourgos Kolilekas ◽  
Konstantinos Kagouridis ◽  
...  
Keyword(s):  
Oxygen Consumption ◽  
Exercise Testing ◽  
Risk Estimation ◽  
Minute Ventilation ◽  
Cardiopulmonary Exercise Testing ◽  
Lung Mechanics ◽  
Peak Oxygen Consumption ◽  
Exercise Limitation ◽  
Cardiopulmonary Exercise

Background. In IPF, defects in lung mechanics and gas exchange manifest with exercise limitation due to dyspnea, the most prominent and disabling symptom.Aim. To evaluate the role of exercise testing through the 6MWT (6-minute walk test) and CPET (cardiopulmonary exercise testing) in the survival of patients with IPF.Methods. This is a prospective, observational study evaluating in 25 patients the relationship between exercise variables through both the 6MWT and CPET and survival.Results. By the end of the observational period 17 patients were alive (33% mortality). Observation ranged from 9 to 64 months. VE/VCO2slope (slope of relation between minute ventilation and CO2production), VO2peak/kg (peak oxygen consumption/kg), VE/VCO2ratio at anaerobic threshold, 6MWT distance, desaturation, and DLCO% were significant predictors of survival while VE/VCO2slope and VO2peak/kg had the strongest correlation with outcome. The optimal model for mortality risk estimation was VO2peak/kg + DLCO% combined. Furthermore, VE/VCO2slope and VO2peak/kg were correlated with distance and desaturation during the 6MWT.Conclusion. The integration of oxygen consumption and diffusing capacity proved to be a reliable predictor of survival because both variables reflect major underlying physiologic determinants of exercise limitation.

Cardiopulmonary Exercise Testing — A Survey of Current Use in England

2009 ◽  
Vol 10 (4) ◽  
pp. 275-278 ◽  
Author(s):  
Joanna C Simpson ◽  
Hannah Sutton ◽  
Michael PW Grocott
Keyword(s):  
Risk Assessment ◽  
Oxygen Consumption ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Perioperative Risk ◽  
Peak Oxygen Consumption ◽  
Telephone Contact ◽  
Cardiopulmonary Exercise ◽  
Oxygen Oxygen ◽  
Patients At Risk

Cardiopulmonary exercise testing (CPET) is an objective method of evaluating integrated cardiopulmonary function. Increasingly, it is being used for perioperative risk assessment. This survey was performed between October and December 2008 to identify where and how CPET is being used for perioperative risk assessment in England. Direct telephone contact was made with the Department of Anaesthesia in 154/173 (89%) of NHS Trusts in England in order to ascertain the availability of a CPET service. One hundred and fifteen (66%) Trusts confirmed whether or not they have a CPET service −30 (17%) Trusts have a CPET service and 12 (7%) are in the process of setting one up. These Trusts were sent a nine-question survey, which was completed by 15 Trusts. Criteria for selecting patients for CPET testing included type of surgery, age and co-morbidities. All trusts use anaerobic threshold (AT) values to identify patients at risk of adverse outcome, though many also used additional variables including peak oxygen consumption, ventilatory equivalents for carbon dioxide, ventilatory equivalents for oxygen, oxygen pulse, oxygen consumption/power slope and breathing reserve. Different numerical threshold values were used in different centres. Patients identified as high risk were managed in a variety of ways, including referral for specialist advice, modifying or cancelling surgery, modified perioperative care and augmented postoperative care (in a level 2 or 3 environment). This survey clearly highlights significant inconsistency in the use of CPET for perioperative risk assessment and suggests that some standardisation of practice may be of value.

scholarly journals Revisiting and Implementing the Weber and Ventilatory Functional Classifications in Heart Failure by Cardiopulmonary Imaging Phenotyping

2021 ◽  
Author(s):  
Marco Guazzi ◽  
Barry Borlaug ◽  
Marco Metra ◽  
Maurizio Losito ◽  
Francesco Bandera ◽  
...  
Keyword(s):  
Heart Failure ◽  
Carbon Dioxide ◽  
Oxygen Consumption ◽  
Mitral Regurgitation ◽  
Ejection Fraction ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Carbon Dioxide Production ◽  
Peak Oxygen Consumption ◽  
Cardiopulmonary Exercise

Background In heart failure, the exercise gas exchange Weber (A to D) and ventilatory classifications (VC‐1 to VC‐4) historically define disease severity and prognosis. However, their applications in the modern heart failure population of any left ventricular ejection fraction combined with hemodynamics are undefined. We aimed at revisiting and implementing these classifications by cardiopulmonary exercise testing imaging. Methods and Results 269 patients with heart failure with reduced (n=105), mid‐range (n=88) and preserved (n=76) ejection fraction underwent cardiopulmonary exercise testing imaging, primarily assessing the cardiac output (CO), mitral regurgitation, and mean pulmonary arterial pressure (mPAP)/CO slope. Within both classes, a progressively lower exercise CO, higher mPAP/CO slopes, and mitral regurgitation ( P <0.01 all) were observed. After adjustment for age and sex, Cox proportional hazard regression analyses showed that Weber (hazard ratio [HR], 2.9; 95% CI, 1.8–4.7; P <0.001) and ventilatory classes (HR, 1.4; 95% CI, 1.1–2.0; P =0.017) were independently associated with outcome. The best stratification was observed when combining Weber (A/B or C/D) with severe ventilation inefficiency (VC‐4) (HR, 2.7; 95% CI, 1.6–4.8; P <0.001). At multivariable analysis the best hemodynamic determinants of peak oxygen consumption and ventilation to carbon dioxide production slope were CO (β‐coefficient, 0.72±0.16; P <0.001) and mPAP/CO slope (β‐coefficient, 0.72±0.16; P <0.001), respectively. Conclusions In the contemporary heart failure population, the Weber and ventilatory classifications maintain their prognostic ability, especially when combined. Exercise CO and mPAP/CO slope are the best predictors of peak oxygen consumption and ventilation to carbon dioxide production slope classifications representing the main targets of interventions to impact functional class and, likely, event rate.

scholarly journals Cardiopulmonary Exercise Testing—A Valuable Tool, Not Gatekeeper When Referring Patients With Adult Congenital Heart Disease for Transplant Evaluation

2019 ◽  
Vol 10 (3) ◽  
pp. 286-291 ◽  
Author(s):  
Jonathan N. Menachem ◽  
Nosheen Reza ◽  
Jeremy A. Mazurek ◽  
Danielle Burstein ◽  
Edo Y. Birati ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Exercise Testing ◽  
Congenital Heart ◽  
Adult Congenital Heart Disease ◽  
Cardiopulmonary Exercise Testing ◽  
Peak Oxygen Consumption ◽  
Cardiopulmonary Exercise ◽  
Advanced Therapies ◽  
Adult Congenital

Introduction: Treatment of patients with adult congenital heart disease (ACHD) with advanced therapies including heart transplant (HT) is often delayed due to paucity of objective prognostic markers for the severity of heart failure (HF). While the utility of Cardiopulmonary Exercise Testing (CPET) in non-ACHD patients has been well-defined as it relates to prognosis, CPET for this purpose in ACHD is still under investigation. Methods: We performed a retrospective cohort study of 20 consecutive patients with ACHD who underwent HT between March 2010 and February 2016. Only 12 of 20 patients underwent CPET prior to transplantation. Demographics, standard measures of CPET interpretation, and 30-day and 1-year post transplantation outcomes were collected. Results: Patient Characteristics. Twenty patients with ACHD were transplanted at a median of 40 years of age (range: 23-57 years). Of the 12 patients who underwent CPET, 4 had undergone Fontan procedures, 4 had tetralogy of Fallot, 3 had d-transposition of the great arteries, and 1 had Ebstein anomaly. Thirty-day and one-year survival was 100%. All tests included in the analysis had a peak respiratory quotient _1.0. The median peak oxygen consumption per unit time (_VO2) for all diagnoses was 18.2 mL/kg/min (46% predicted), ranging from 12.2 to 22.6. Conclusion: There is a paucity of data to support best practices for patients with ACHD requiring transplantation. While it cannot be proven based on available data, it could be inferred that outcomes would have been worse or perhaps life sustaining options unavailable if providers delayed referral because of the lack of attainment of CPET-specific thresholds.

scholarly journals Ventilatory compensation during the incremental exercise test is inversely correlated with air trapping in COPD

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1661
Author(s):  
Rottem Kuint ◽  
Neville Berkman ◽  
Samir Nusair
Keyword(s):  
Gas Exchange ◽  
Exercise Testing ◽  
Exercise Test ◽  
Cardiopulmonary Exercise Testing ◽  
Incremental Exercise ◽  
Peak Oxygen Consumption ◽  
Air Trapping ◽  
Incremental Exercise Test ◽  
Cardiopulmonary Exercise ◽  
Copd Patients

Background: Air trapping and gas exchange abnormalities are major causes of exercise limitation in chronic obstructive pulmonary disease (COPD). During incremental cardiopulmonary exercise testing, ventilatory equivalents for carbon dioxide (VE/VCO2) and oxygen (VE/VO2) may be difficult to identify in COPD patients because of limited ventilatory compensation capacity. Therefore, we aimed to detect a possible correlation between the magnitude of ventilation augmentation, as manifested by increments in ventilatory equivalents from nadir to peak effort values and air trapping, detected with static testing.    Methods: In this observational study, we studied data obtained previously from 20 COPD patients who, during routine follow-up, underwent a symptom-limited incremental exercise test and in whom a plethysmography was obtained concurrently. Air trapping at rest was assessed by measurement of the residual volume (RV) to total lung capacity (TLC) ratio (RV/TLC). Gas exchange data collected during the symptom-limited incremental cardiopulmonary exercise test allowed determination of the nadir and peak effort values of VE/VCO2 and VE/VO2, thus enabling calculation of the difference between peak effort value and nadir values of  VE/VCO2 and VE/VO2, designated ΔVE/VCO2 and ΔVE/VO2, respectively. Results: We found a statistically significant inverse correlation between both ΔVE/VCO2 (r = -0. 5058, 95% CI -0.7750 to -0.08149, p = 0.0234) and ΔVE/VO2 (r = -0.5588, 95% CI -0.8029 to -0.1545, p = 0.0104) and the degree of air trapping (RV/TLC). There was no correlation between                ΔVE/VCO2 and peak oxygen consumption, forced expiratory volume in the first second, or body mass index.  Conclusions: The ventilatory equivalents increment to compensate for acidosis during incremental exercise testing was inversely correlated with air trapping (RV/TLC) and may be a candidate prognostic biomarker.

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