The Role of Gas Exchange Variables in Cardiopulmonary Exercise Testing for Risk Stratification and Management of Heart Failure with Reduced Ejection Fraction - 31/07/18
Abstract |
Heart failure with reduced ejection fraction (HFrEF) is common in the developed world and results in significant morbidity and mortality. Accurate risk assessment methods and prognostic variables are therefore needed to guide clinical decision making for medical therapy and surgical interventions with the ultimate goal of decreasing risk and improving health outcomes.
The purpose of this review is to examine the role of cardiopulmonary exercise testing (CPET) and its most commonly used ventilatory gas exchange variables for the purpose of risk stratification and management of HFrEF.
We evaluated five widely studied gas exchange variables from CPET in HFrEF patients based on nine previously used systematic criteria for biomarkers. This paper provides clinicians with a comprehensive and critical overview, class recommendations and evidence levels.
Although some CPET variables met more criteria than others, evidence supporting the clinical assessment of variables beyond peak V̇O2 is well-established. A multi-variable approach also including the V̇E-V̇CO2 slope and EOV is therefore recommended.
Le texte complet de cet article est disponible en PDF.Abbreviations : CPET, EOV, HFpEF, HFrEF, NRI, OUES, PETCO2, V̇CO2, V̇E, V̇O2
Plan
| Conflicts of Interest: The authors of this manuscript received no specific grant for writing this manuscript from any funding agency in the public, commercial, or not-for-profit sectors. Jonathan Wagner: Conflicts of Interest: none declared Piergiuseppe Agostoni: Advisory Board Novartis, no further disclosures Ross Arena: Conflicts of Interest: none declared Romualdo Belardinelli: Conflicts of Interest: none declared Daniel Dumitrescu: Conflicts of Interest: none declared Alfred Hager: Research Grants: Pfizer, GlaxoSmithKline, Abbott, Actelion, Medtronic and many other companies; other research support: Actelion Medtronic, Edwards, Occlutec, Novartis, Lilly, Pfizer, Gore, Occlutech, Bristol-Myers Squibb, Daiichi Sankyo, Asklepion Ceres, Beijing Med-Zenith, Venus Med-Tech, and many other companies; honoraria: AbottVirology, Encysive GmbH, Pfizer, Actelion, Abott, Medtronic, Schiller Medizintechnik GmbH, GlaxoSmithKline, AOP Orphan Pharamaceuticals AG and OMT; Ownership Interest: Johnson & Johnson, Gilead, Merck Sharp & Dohme Inc, Pfizer, Medtronic, Roche and many other biotech companies and Advisory Board Actelion. Jonathan Myers: Conflicts of Interest: none declared Rainer Rauramaa: Conflicts of Interest: none declared Marshall Riley: Conflicts of Interest: none declared Tim Takken: Conflicts of Interest: none declared Arno Schmidt-Trucksäss: Conflicts of Interest: none declared |
Vol 202
P. 116-126 - août 2018 Retour au numéro
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