ABSTRACT
Background
Cardiopulmonary exercise testing (CPET) can identify mechanisms of exercise intolerance
in heart failure with preserved ejection fraction (HFpEF), but exercise modalities
with differing body positions (eg, recumbent ergometer, treadmill) are broadly used.
In this study, we aimed to determine whether body position affects CPET parameters
in patients with HFpEF.
Methods
Subjects with stable HFpEF (n = 23) underwent noninvasive treadmill CPET, followed
by an invasive recumbent-cycle ergometer CPET within 3 months. A comparison group
undergoing similar studies included healthy subjects (n = 5) and subjects with pulmonary
arterial hypertension (n = 6).
Results
The peak oxygen consumption (VO2peak) and peak heart rate were significantly lower in the recumbent vs the upright
position (10.1 vs 13.1 mL/kg/min [Δ–3 mL/kg/min]; P < 0.001; and 95 vs 113 bpm [Δ–18 bpm]; P < 0.001, respectively). No significant differences were found in the minute ventilation
to carbon dioxide production ratio, end-tidal pressure of carbon dioxide or respiratory
exchange ratio. A similar pattern was observed in the comparison groups.
Conclusions
Compared to recumbent ergometer, treadmill CPET revealed higher VO2peak and peak heart rate response. When determining chronotropic incompetence to adjust
beta-blocker administration in HFpEF, body position should be taken into account.
Key Words
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Article info
Publication history
Published online: October 12, 2022
Accepted:
September 14,
2022
Received in revised form:
September 8,
2022
Received:
June 24,
2022
Madison, Wisconsin, and Philadelphia, PennsylvaniaIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
