Post-Exercise Oxygen Uptake Recovery Delay
| Autor: | Luke Wooster, Gregory D. Lewis, Cole S. Bailey, Kristian Bakken, Rajeev Malhotra, Mary D. Buswell, Casey White, Paul P. Pappagianopoulos, Melissa Tanguay, Sarvagna Patel, Aaron L. Baggish, Jasmine B Blodgett |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Cardiac output Ejection fraction business.industry Cardiac reserve Cardiopulmonary exercise testing 030204 cardiovascular system & hematology medicine.disease Oxygen uptake 03 medical and health sciences 0302 clinical medicine Interquartile range Internal medicine Heart failure Cohort medicine Cardiology 030212 general & internal medicine Cardiology and Cardiovascular Medicine business |
| Zdroj: | JACC: Heart Failure. 6:329-339 |
| ISSN: | 2213-1779 |
| DOI: | 10.1016/j.jchf.2018.01.007 |
| Popis: | Objectives This study sought to characterize the functional and prognostic significance of oxygen uptake (VO2) kinetics following peak exercise in individuals with heart failure (HF). Background It is unknown to what extent patterns of VO2 recovery following exercise reflect circulatory response during exercise in HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF). Methods We investigated patients (30 HFpEF, 20 HFrEF, and 22 control subjects) who underwent cardiopulmonary exercise testing with invasive hemodynamic monitoring and a second distinct HF cohort (n = 106) who underwent noninvasive cardiopulmonary exercise testing with assessment of long-term outcomes. Fick cardiac output (CO) and cardiac filling pressures were measured at rest and throughout exercise in the initial cohort. A novel metric, VO2 recovery delay (VO2RD), defined as time until post-exercise VO2 falls permanently below peak VO2, was measured to characterize VO2 recovery kinetics. Results VO2RD in patients with HFpEF (median 25 s [interquartile range (IQR): 9 to 39 s]) and HFrEF (28 s [IQR: 2 to 52 s]) was in excess of control subjects (5 s [IQR: 0 to 7 s]; p Conclusions Post-exercise VO2RD is an easily recognizable, noninvasively derived pattern that signals impaired cardiac output augmentation during exercise and predicts outcomes in HF. The presence and duration of VO2RD may complement established exercise measurements for assessment of cardiac reserve capacity. |
| Databáze: | OpenAIRE |
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