Cardiopulmonary Exercise Variables in Diastolic Versus Systolic Heart Failure

The response to cardiopulmonary exercise (CPX) in patients with heart failure (HF) with normal left ventricular (LV) ejection fractions (EFs) is not well characterized. To determine if CPX testing could distinguish between patients with HF with normal EFs (>50%; i.e., diastolic HF) and those with...

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Bibliographic Details
Published in:The American journal of cardiology 2008-07, Vol.102 (2), p.203-206
Main Authors: Farr, Mary Jane, MD, Lang, Chim C., MD, LaManca, John J., PhD, Zile, Michael R., MD, Francis, Gary, MD, Tavazzi, Luigi, MD, Gaasch, William H., MD, St. John Sutton, Martin, MD, Itoh, Haruki, MD, Mancini, Donna, MD
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Blood pressure
Carbon dioxide
Cardiology
Cardiology. Vascular system
Cardiovascular
Clinical trials
Double-Blind Method
Exercise
Exercise Test - methods
Female
Heart
Heart failure
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Heart Failure, Diastolic - diagnostic imaging
Heart Failure, Diastolic - physiopathology
Heart Failure, Systolic - diagnostic imaging
Heart Failure, Systolic - physiopathology
Heart Function Tests
Humans
Male
Medical sciences
Middle Aged
Oxygen Consumption
Stroke Volume
Ultrasonography
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Summary:The response to cardiopulmonary exercise (CPX) in patients with heart failure (HF) with normal left ventricular (LV) ejection fractions (EFs) is not well characterized. To determine if CPX testing could distinguish between patients with HF with normal EFs (>50%; i.e., diastolic HF) and those with decreased EFs (≥50%; i.e., systolic HF), CPX responses were compared between 185 patients with systolic HF (79% men, mean age 62.6 ± 10.9 years) and 43 with diastolic HF (54% men, mean age 67.4 ± 9.8 years) enrolled in a phase II multicenter clinical trial. All patients were evaluated with echocardiography and a standardized CPX test as part of the trial. CPX variables, including oxygen uptake at peak exercise (peak VO 2 ) and the slope of the ventilation/carbon dioxide production ratio (VE/VCO 2 ), were determined and analyzed by core laboratory personnel. Echocardiographic measurements included the LV EF, the E/A ratio, filling time, cavity volumes, right ventricular function, and mitral regurgitation. Patients in the diastolic HF group tended to be older (p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2008.03.041