[Recent advance of exercise test in clinical cardiology concerning heart failure].
Present review focused on the recent advance and clinical application of exercise test in cardiology. Exercise intolerance is considered as one of clinical essential feature in patients with heart failure. Cardiac dysfunction induces systemic disorders including motor muscle and vasculature, and then limits exercise performance through direct and indirect pathway. Parameters of exercise test consist of subjective indexes such as NYHA functional class, and objective evaluations such as cardiopulmonary exercise test(CPX). Especially, we discussed the parameters of CPX provided many indexes, for example peak VO2, VE/VCO2 slope and deltaVO2/Work rate. These various indexes have different clinical meanings among each other. Low value of peak VO2, which reflected both disturbances of central and peripheral factors, is reported to result in poor survival rate. Although VE/VCO2 slope similarly predicts the prognosis, it thought to be mediated through a different way. We concluded that exercise test is important to understand the pathophysiological feature of heart failure as a systemic disease.
Fukuma
Nagaharu
N
1st Department of Internal Medicine, Nippon Medical School.
Takayama
Morimasa
M