Complications of the cardiopulmonary stress test in patients with depressed left ventricular systolic function.
BACKGROUND
The exercise test has a recognized lower risk of complications when used in the general population and in coronary artery diseased patients, but from a theoretical point of view should have a higher rate of complications when performed in patients with chronic heart failure (CHF).


OBJECTIVE
To characterize and assess the type and incidence of complications during cardiopulmonary stress test (CPX) in patients with depressed left ventricular systolic function in comparison with a group of patients and individuals with normal function.


METHODS
Retrospective analysis of the 334 consecutive CPX performed for risk stratification in 198 patients with a left ventricular ejection fraction below 40% (Group A) and 180 consecutive CPX performed in 78 subjects with normal function (Group B). The two groups were compared with respect to demographic data, CPX parameters and specific complications.


RESULTS
Major complications during the tests occurred only in 14 tests of Group A (4.2%, p = 0.012). Non-sustained ventricular tachycardia, <6 beats, occurred in 7 group A and 2 group B tests. The absence of coronary artery disease was the only independent predictor for complications.


CONCLUSIONS
Major CPX complications occurred only in patients with impaired left ventricular systolic function. Heart failure patients showed a low probability (around 4%) for complications during CPX, significantly higher and more severe than the risk in the group of patients with normal ventricular function, allowing us to recommend that CPX in patients with heart failure should be performed in a hospital setting under the supervision of a physician with specific training.
Timóteo
Ana T
AT
Serviço de Cardiologia, Hospital de Santa Cruz, Camaxide, Portugal. ana_timoteo@yahoo.com
Mendes
Miguel
M
Aguiar
Carlos T
CT
Barbaça
Ana
A
Seabra-Gomes
Ricardo
R
D005080:Exercise Test / Q000009:adverse effects*; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000150:complications*