title: A new cardiopulmonary exercise testing prognosticating algorithm for heart failure patients treated with beta-blockers.
abstract: In 2004, a cardiopulmonary exercise testing (CPET) prognosticating algorithm for heart failure (HF) patients was proposed. The algorithm employed a stepwise assessment of peak oxygen consumption (VO2), slope of regression relating minute ventilation to carbon dioxide output (VE/VCO2) and peak respiratory exchange ratio (RER), and was proposed as an alternative to the traditional strategy of using a single CPET parameter to describe prognosis. Since its initial proposal, the prognosticating algorithm has not been reassessed, although a re-evaluation is in order given the fact that new HF therapies, such as beta-blocker therapy, have significantly improved survival in HF. The present review, based on a critical examination of CPET outcome studies in HF patients regularly treated with beta-blockers, suggests a new prognosticating algorithm. The algorithm comprises four CPET parameters: peak RER, exertional oscillatory ventilation (EOV), peak VO2 and peak systolic blood pressure (SBP). Compared to previous proposals, the present preliminary attempt includes EOV instead of VE/VCO2 slope as ventilatory CPET parameter, and peak SBP as hemodynamic-derived index.
authors: Division of Cardiology, Laboratory for the Analysis of Cardio-respiratory Signals, Salvatore Maugeri Foundation, IRCCS, Via per Revislate 13, Veruno, NO, Italy. ucorra@fsm.it
authors: Ugo
authors: U
authors: Corrà
authors: Alessandro
authors: A
authors: Mezzani
authors: Andrea
authors: A
authors: Giordano
authors: Roberto
authors: R
authors: Caruso
authors: Pantaleo
authors: P
authors: Giannuzzi
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D000465:Algorithms; D002245:Carbon Dioxide / Q000378:metabolism; D005080:Exercise Test / Q000379:methods*; D017079:Exercise Tolerance / Q000187:drug effects*; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D010101:Oxygen Consumption; D011379:Prognosis; D012372:ROC Curve
chemical_list: D000319:Adrenergic beta-Antagonists; D002245:Carbon Dioxide