Cardiopulmonary Exercise Testing in Heart Failure
Cardiopulmonary Exercise Testing in Heart Failure
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DOI：
10.1016/j.jchf.2016.03.022
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发表时间：
2016-08-01
影响因子：
13
通讯作者：
Lewis, Gregory D.
中科院分区：
文献类型：
--
作者：
Malhotra, Rajeev;Bakken, Kristian;Lewis, Gregory D.
运动不耐受是心力衰竭（HF）的主要表现，表现为运动时的呼吸困难和疲劳。心肺运动试验（CPET）通过测量峰值摄氧量（VO2）精确定义最大运动能力。峰值VO2值在告知患者选择高级HF干预（如心脏移植和心室辅助装置）方面具有关键作用。在CPET的次极量部分获得的摄氧量和呼吸模式也是有价值的，因为它们在低水平运动时易于确定，与日常生活活动能力相关，独立于意志努力，与HF预后密切相关。VO2峰值和其他CPET变量可重复测量并准确反映HF严重程度的能力越来越多地得到科学声明的认可和认可。运动期间CPET与有创血流动力学监测和心脏成像的整合提供了多系统储备能力的全面表征，可以告知预后和心脏干预的需要。在这里，我们回顾了在HF患者中进行CPEAST的临床和研究目的以及解释临床前HF到晚期HF的气体交换模式的实际方面。(C)2016年由美国心脏病学会基金会。
Exercise intolerance, indicated by dyspnea and fatigue during exertion, is a cardinal manifestation of heart failure (HF). Cardiopulmonary exercise testing (CPET) precisely defines maximum exercise capacity through measurement of peak oxygen uptake (VO2). Peak VO2 values have a critical role in informing patient selection for advanced HF interventions such as heart transplantation and ventricular assist devices. Oxygen uptake and ventilatory patterns obtained during the submaximal portion of CPET are also valuable to recognize because of their ease of ascertainment during low-level exercise, relevance to ability to perform activities of daily living, independence from volitional effort, and strong relationship to prognosis in HF. The ability of peak VO2 and other CPET variables to be measured reproducibly and to accurately reflect HF severity is increasingly recognized and endorsed by scientific statements. Integration of CPET with invasive hemodynamic monitoring and cardiac imaging during exercise provides comprehensive characterization of multisystem reserve capacity that can inform prognosis and the need for cardiac interventions. Here, we review both practical aspects of conducting CPETs in patients with HF for clinical and research purposes as well as interpretation of gas exchange patterns across the spectrum of preclinical HF to advanced HF. (C) 2016 by the American College of Cardiology Foundation.