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Work‐rate affects cardiopulmonary exercise test results in heart failure
Author(s) -
Agostoni Piergiuseppe,
Bianchi Michele,
Moraschi Andrea,
Palermo Pietro,
Cattadori Gaia,
La Gioia Rocco,
Bussotti Maurizio,
Wasserman Karlman
Publication year - 2005
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2004.06.007
Subject(s) - medicine , heart rate , heart failure , work rate , cardiopulmonary exercise test , cardiology , population , ventilation (architecture) , vo2 max , physical therapy , anesthesia , blood pressure , mechanical engineering , environmental health , engineering
Aims Cardiopulmonary exercise test (CPET) is used to evaluate patients with chronic heart failure (HF) usually by means of a personalized ramp exercise protocol. Our aim was to evaluate if exercise duration or ramp rate influences the results. Methods and results Ninety HF patients were studied (peak V O 2 : >20 ml/min/kg, n =28, 15>20 ml/min/kg, n =39 and <15 ml/min/kg, n =23). Each patient did four CPET studies. The initial study was used to separate the subjects into three groups, according to their exercise capacity. In the remaining studies, work‐rate was increased at three different rates designed to have the subjects reach peak exercise in 5, 10 and 15 min from the start of the ramp increase in work‐rate, respectively. The order was randomized. The work‐rate applied for the total population averaged 22.7±8.0, 11.6±3.7, 7.5±2.9 W/min with effective loaded exercise duration of 5 min and 16 s±29 s, 9 min and 43 s±49 s and 14 min and 32 s±1 min and 12 s for the 5‐, 10‐ and 15‐min tests, respectively. Peak averaged 16.9±4.3*, 18.0±4.4 and 18.0±5.4 ml/min/kg for the 5‐, 10‐ and 15‐min tests, (*= p <0.001 vs. 10 min). The shortest test had the lowest peak heart rate and ventilation and highest peak work‐rate. Peak and heart rate were lowest in 5‐min tests regardless of HF severity. The δ/δwork‐rate was lowest in 5‐min tests and highest in 15‐min tests. At all ramp rates, δ/δwork‐rate was lower for the subjects with the lower peak . The slope and at anaerobic threshold were not affected by the protocol for any grade of HF. Conclusions In chronic HF, exercise protocol has a small effect on peak and δ/δwork but does not affect at anaerobic threshold and slope.