Journal of Cardiac Failure
Volume 15, Issue 6 , Pages 482-488 , August 2009

Ventilatory Expired Gas at Constant-Rate Low-Intensity Exercise Predicts Adverse Events and is Related to Neurohormonal Markers in Patients With Heart Failure

  • Ross Arena, PhD, PT

      Affiliations

    • Department of Physical Therapy, Virginia Commonwealth University, Health Sciences Campus, Richmond, Virginia
    • Department of Internal Medicine, Virginia Commonwealth University, Health Sciences Campus, Richmond, Virginia
    • Corresponding Author InformationCorrespondence to: Ross Arena, PhD, PT, Associate Professor, Department of Physical Therapy, Box 980224, Virginia Commonwealth University, Health Sciences Campus, Richmond, VA 23298-0224. Tel: 804-828-0234.
    • ,
  • Dean MacCarter, PhD

      Affiliations

    • Aurora Denver Cardiology, Denver, Colorado
    • ,
  • Thomas P. Olson, PhD

      Affiliations

    • Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
    • ,
  • Sophie Lalande, PhD

      Affiliations

    • Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
    • ,
  • Maile L. Ceridon, PhD

      Affiliations

    • Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
    • ,
  • Lyle J. Olson, MD

      Affiliations

    • Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
    • ,
  • Bruce Johnson, PhD

      Affiliations

    • Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota

Received 4 September 2008 ,Revised 19 December 2008 ,Accepted 22 December 2008.

References 

  1. Gibbons RJ, Balady GJ, Timothy BJ, Chaitman BR, Fletcher GF, Froelicher VF, et al. ACC/AHA 2002 guideline update for exercise testing: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). J Am Coll Cardiol. 2002;40:1531–1540
  2. Arena R, Myers J, Williams MA, Gulati M, Kligfield P, Balady GJ, et al. Assessment of functional capacity in clinical and research settings: a scientific statement from the American Heart Association Committee on Exercise, Rehabilitation, and Prevention of the Council on Clinical Cardiology and the Council on Cardiovascular Nursing. Circulation. 2007;116:329–343
  3. Arena R, Myers J, Guazzi M. The clinical and research applications of aerobic capacity and ventilatory efficiency in heart failure: an evidence-based review. Heart Fail Rev. 2008;13:245–269
  4. Mancini DM, Eisen H, Kussmaul W, Mull R, Edmunds LH, Wilson JR. Value of peak exercise oxygen consumption for optimal timing of cardiac transplantation in ambulatory patients with heart failure. Circulation. 1991;83:778–786
  5. Arena R, Myers J, Abella J, Peberdy MA, Bensimhon D, Chase P, et al. Development of a Ventilatory Classification System in Patients With Heart Failure. Circulation. 2007;115:2410–2417
  6. 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
  7. Gitt AK, Wasserman K, Kilkowski C, Kleemann T, Kilkowski A, Bangert M, et al. Exercise anaerobic threshold and ventilatory efficiency identify heart failure patients for high risk of early death. Circulation. 2002;106:3079–3084
  8. MacGowan GA, Janosko K, Cecchetti A, Murali S. Exercise-related ventilatory abnormalities and survival in congestive heart failure. Am J Cardiol. 1997;79:1264–1266
  9. Arena R, Guazzi M, Myers J. Prognostic value of end-tidal carbon dioxide during exercise testing in heart failure. Int J Cardiol. 2007;117:103–108
  10. Koike A, Itoh H, Kato M, Sawada H, Aizawa T, Fu LT, et al. Prognostic power of ventilatory responses during submaximal exercise in patients with chronic heart disease. Chest. 2002;121:1581–1588
  11. Corra U, Giordano A, Bosimini E, Mezzani A, Piepoli M, Coats AJ, et al. Oscillatory ventilation during exercise in patients with chronic heart failure: clinical correlates and prognostic implications. Chest. 2002;121:1572–1580
  12. Koike A, Koyama Y, Itoh H, Adachi H, Marumo F, Hiroe M. Prognostic significance of cardiopulmonary exercise testing for 10-year survival in patients with mild to moderate heart failure. Jpn Circ J. 2000;64:915–920
  13. Brunner-La Rocca HP, Weilenmann D, Schalcher C, Schlumpf M, Follath F, Candinas R, et al. Prognostic significance of oxygen uptake kinetics during low level exercise in patients with heart failure. Am J Cardiol. 1999;84:741–744A9
  14. Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14:377–381
  15. Yasue H, Yoshimura M, Sumida H, Kikuta K, Kugiyama K, Jougasaki M, et al. Localization and mechanism of secretion of B-type natriuretic peptide in comparison with those of A-type natriuretic peptide in normal subjects and patients with heart failure. Circulation. 1994;90:195–203
  16. Burnett JC, Kao PC, Hu DC, Heser DW, Heublein D, Granger JP, et al. Atrial natriuretic peptide elevation in congestive heart failure in the human. Science. 1986;231:1145–1147
  17. Piepoli MF, Corra U, Agostoni PG, Belardinelli R, Cohen-Solal A, Hambrecht R, et al. Statement on cardiopulmonary exercise testing in chronic heart failure due to left ventricular dysfunction: recommendations for performance and interpretation Part II: how to perform cardiopulmonary exercise testing in chronic heart failure. Eur J Cardiovasc Prev Rehabil. 2006;13:300–311
  18. Piepoli MF, Corra U, Agostoni PG, Belardinelli R, Cohen-Solal A, Hambrecht R, et al. Statement on cardiopulmonary exercise testing in chronic heart failure due to left ventricular dysfunction: recommendations for performance and interpretation. Part I: definition of cardiopulmonary exercise testing parameters for appropriate use in chronic heart failure. Eur J Cardiovasc Prev Rehabil. 2006;13:150–164
  19. Piepoli MF, Corra U, Agostoni PG, Belardinelli R, Cohen-Solal A, Hambrecht R, et al. Statement on cardiopulmonary exercise testing in chronic heart failure due to left ventricular dysfunction: recommendations for performance and interpretation Part III: interpretation of cardiopulmonary exercise testing in chronic heart failure and future applications. Eur J Cardiovasc Prev Rehabil. 2006;13:485–494
  20. O'Neill JO, Young JB, Pothier CE, Lauer MS. Peak oxygen consumption as a predictor of death in patients with heart failure receiving {beta}-blockers. Circulation. 2005;111:2313–2318
  21. Lipinski MJ, Vetrovec GW, Gorelik D, Froelicher VF. The importance of heart rate recovery in patients with heart failure or left ventricular systolic dysfunction. J Card Failure. 2005;11:624–630
  22. Arena R, Myers J, Aslam S, Varughese EB, Peberdy MA. Technical considerations related to the minute ventialtion/carbon dioxide output slope in patients with heart failure. Chest. 2003;124:720–727
  23. 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
  24. 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
  25. Kruger S, Graf Ju, Kunz D, Stickel T, Hanrath P, Janssens U. brain natriuretic peptide levels predict functional capacity in patients with chronic heart failure. J Am Coll Cardiol. 2002;40:718–722
  26. Scardovi AB, De MR, Coletta C, Aspromonte N, Perna S, Infusino T, et al. Brain natriuretic peptide is a reliable indicator of ventilatory abnormalities during cardiopulmonary exercise test in heart failure patients. Med Sci Monit. 2006;12:CR191–CR195
  27. Tanabe Y, Hosaka Y, Ito M, Ito E, Suzuki K. Significance of end-tidal P(CO(2)) response to exercise and its relation to functional capacity in patients with chronic heart failure. Chest. 2001;119:811–817
  28. Matsumoto A, Itoh H, Eto Y, Kobayashi T, Kato M, Omata M, et al. End-tidal CO2 pressure decreases during exercise in cardiac patients: association with severity of heart failure and cardiac output reserve. J Am Coll Cardiol. 2000;36:242–249

PII: S1071-9164(08)01115-9

doi: 10.1016/j.cardfail.2008.12.015

Journal of Cardiac Failure
Volume 15, Issue 6 , Pages 482-488 , August 2009

Article Tools

* Image Usage & Resolution