Journal of Cardiac Failure
Volume 13, Issue 6 , Pages 462-469 , August 2007

The Minute Ventilation/Carbon Dioxide Production Slope is Prognostically Superior to the Oxygen Uptake Efficiency Slope

  • Ross Arena, PhD, PT

      Affiliations

    • From the Departments of Physical Therapy, Virginia Commonwealth University, Health Sciences Campus, Richmond, Virginia
    • Corresponding Author InformationReprint requests: Ross Arena, PhD, PT, Assistant Professor, Department of Physical Therapy, Box 980224, Virginia Commonwealth University, Health Sciences Campus, Richmond, VA 23298-0224.
    • ,
  • Jonathan Myers, PhD

      Affiliations

    • VA Palo Alto Health Care System, Cardiology Division, Stanford University, Palo Alto, California
    • ,
  • Leon Hsu, BS

      Affiliations

    • VA Palo Alto Health Care System, Cardiology Division, Stanford University, Palo Alto, California
    • ,
  • Mary Ann Peberdy, MD

      Affiliations

    • Internal Medicine, Virginia Commonwealth University, Health Sciences Campus, Richmond, Virginia
    • ,
  • Sherry Pinkstaff, BS

      Affiliations

    • From the Departments of Physical Therapy, Virginia Commonwealth University, Health Sciences Campus, Richmond, Virginia
    • ,
  • Daniel Bensimhon, MD

      Affiliations

    • LeBauer Cardiovascular Research Foundation, Greensboro, North Carolina
    • ,
  • Paul Chase, MEd

      Affiliations

    • LeBauer Cardiovascular Research Foundation, Greensboro, North Carolina
    • ,
  • Marco Vicenzi, MS

      Affiliations

    • University of Milano, San Paolo Hospital, Cardiopulmonary Laboratory, Cardiology Division, Milano, Italy
    • ,
  • Marco Guazzi, MD, PhD

      Affiliations

    • University of Milano, San Paolo Hospital, Cardiopulmonary Laboratory, Cardiology Division, Milano, Italy

Received 26 January 2007 ,Revised 20 February 2007 ,Accepted 7 March 2007.

References 

  1. Arena R, Myers J, Aslam SS, Varughese EB, Peberdy MA. Peak VO2 and VE/VCO2 slope in patients with heart failure: a prognostic comparison. Am Heart J. 2004;147:354–360
  2. Francis DP, Shamim W, Davies LC, Piepoli MF, Ponikowski P, Anker SD, et al. Cardiopulmonary exercise testing for prognosis in chronic heart failure: continuous and independent prognostic value from VE/VCO(2)slope and peak VO(2). Eur Heart J. 2000;21:154–161
  3. Chua TP, Ponikowski P, Harrington D, Anker SD, Webb-Peploe K, Clark AL, et al. Clinical correlates and prognostic significance of the ventilatory response to exercise in chronic heart failure. J Am Coll Cardiol. 1997;29:1585–1590
  4. Robbins M, Francis G, Pashkow FJ, Snader CE, Hoercher K, Young JB, et al. Ventilatory and heart rate responses to exercise: better predictors of heart failure mortality than peak oxygen consumption. Circulation. 1999;100:2411–2417
  5. Ponikowski P, Francis DP, Piepoli MF, Davies LC, Chua TP, Davos CH, et al. Enhanced ventilatory response to exercise in patients with chronic heart failure and preserved exercise tolerance: marker of abnormal cardiorespiratory reflex control and predictor of poor prognosis. Circulation. 2001;103:967–972
  6. Baba R, Nagashima M, Goto M, Nagano Y, Yokota M, Tauchi N, et al. Oxygen intake efficiency slope: a new index of cardiorespiratory functional reserve derived from the relationship between oxygen consumption and minute ventilation during incremental exercise. Nagoya J Med Sci. 1996;59:55–62
  7. Van Laethem C, Bartunek J, Goethals M, Nellens P, Andries E, Vanderheyden M. Oxygen uptake efficiency slope, a new submaximal parameter in evaluating exercise capacity in chronic heart failure patients. Am Heart J. 2005;149:175–180
  8. Davies LC, Wensel R, Georgiadou P, Cicoira M, Coats AJ, Piepoli MF, et al. Enhanced prognostic value from cardiopulmonary exercise testing in chronic heart failure by non-linear analysis: oxygen uptake efficiency slope. Eur Heart J. 2006;27:684–690
  9. Hunt SA. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure). JACC. 2005;46:e1–e82
  10. Cheitlin MD, Armstrong WF, Aurigemma GP, Beller GA, Bierman FZ, Davis JL, et al. ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography). Circulation. 2003;108:1146–1162
  11. Guazzi M, Myers J, Arena R. Cardiopulmonary exercise testing in the clinical and prognostic assessment of diastolic heart failure. J Am Coll Cardiol. 2005;46:1883–1890
  12. Arena R, Humphrey R, Peberdy MA, Madigan M. Predicting peak oxygen consumption during a conservative ramping protocol: implications for the heart failure population. J Cardiopulm Rehabil. 2003;23:183–189
  13. Hanley JA, McNeil BJ. A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology. 1983;148:839–843
  14. MacGowan GA, Murali S. Ventilatory and heart rate responses to exercise: better predictors of heart failure mortality than peak exercise oxygen consumption. Circulation. 2000;102:E182
  15. Arena R, Myers J, Aslam SS, Varughese EB, Peberdy MA. Impact of time past exercise testing on prognostic variables in heart failure. Int J Cardiol. 2006;106:88–94
  16. Arena R, Myers J, Aslam S, Varughese EB, Peberdy MA. Technical considerations related to the minute ventilation/carbon dioxide output slope in patients with heart failure. Chest. 2003;124:720–727
  17. Bard RL, Gillespie BW, Clarke NS, Egan TG, Nicklas JM. Determining the best ventilatory efficiency measure to predict mortality in patients with heart failure. J Heart Lung Transplant. 2006;25:589–595
  18. Tabet JY, Beauvais F, Thabut G, Tartiere JM, Logeart D, Cohen-Solal A. A critical appraisal of the prognostic value of the VE/VCO2 slope in chronic heart failure. J Cardiovasc Risk. 2003;10:267–272
  19. Ingle L, Goode K, Carroll S, Sloan R, Boyes C, Cleland JGF, et al. Prognostic value of the VE/VCO2 slope calculated from different time intervals in patients with suspected heart failure. Int J Cardiol. 2007;118:350–355
  20. Uren NG, Davies SW, Agnew JE, Irwin AG, Jordan SL, Hilson AJ, et al. Reduction of mismatch of global ventilation and perfusion on exercise is related to exercise capacity in chronic heart failure. Br Heart J. 1993;70:241–246
  21. Wada O, Asanoi H, Miyagi K, Ishizaka S, Kameyama T, Seto H, et al. Importance of abnormal lung perfusion in excessive exercise ventilation in chronic heart failure. Am Heart J. 1993;125:790–798
  22. Banning AP, Lewis NP, Northridge DB, Elborn JS, Hendersen AH. Perfusion/ventilation mismatch during exercise in chronic heart failure: an investigation of circulatory determinants. Br Heart J. 1995;74:27–33
  23. Lewis NP, Banning AP, Cooper JP, Sundar AS, Facey PE, Evans WD, et al. Impaired matching of perfusion and ventilation in heart failure detected by 133xenon. Basic Res Cardiol. 1996;91(Suppl 1):45–49
  24. Reindl I, Wernecke KD, Opitz C, Wensel R, Konig D, Dengler T, et al. Impaired ventilatory efficiency in chronic heart failure: possible role of pulmonary vasoconstriction. Am Heart J. 1998;136:778–785
  25. Adachi H, Nguyen PH, Belardinelli R, Hunter D, Jung T, Wasserman K. Nitric oxide production during exercise in chronic heart failure. Am Heart J. 1997;134:196–202
  26. Chua TP, Clark AI, Amadi AA, Coats AJS. Relation between chemosensitivity and the ventilatory response to exercise in chronic heart failure. JACC. 1996;27:650–657
  27. Piepoli M, Clark AL, Volterrani M. Contribution of muscle afferents to the hemodynamic, autonomic, and ventilatory responses to exercise in patients with chronic heart failure. Circulation. 1996;93:940–952

PII: S1071-9164(07)00095-4

doi: 10.1016/j.cardfail.2007.03.004

Journal of Cardiac Failure
Volume 13, Issue 6 , Pages 462-469 , August 2007

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