Related Experiment Video

Updated: Jun 23, 2026

A Pacing-Controlled Procedure for the Assessment of Heart Rate-Dependent Diastolic Functions in Murine Heart Failure Models
07:49

A Pacing-Controlled Procedure for the Assessment of Heart Rate-Dependent Diastolic Functions in Murine Heart Failure Models

Published on: July 21, 2023

Exercise haemodynamic variables rather than ventilatory efficiency indexes contribute to risk assessment in chronic

Ugo Corrà1, Alessandro Mezzani, Andrea Giordano

  • 1Laboratory for the Analysis of Cardio-Respiratory Signals, Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Via per Revislate, 13, 28010 Veruno (NO), Italy. ugo.corra@fsm

European Heart Journal
|May 2, 2009
PubMed

Insights

Cardiopulmonary exercise testing (CPET) parameters predict outcomes in chronic heart failure (CHF) patients on beta-blockers. Peak systolic blood pressure (SBP) and peak circulatory power (CP) are strong predictors, with exertional oscillatory ventilation (EOV) offering additional risk stratification.

Area of Science:

  • Cardiology
  • Exercise Physiology
  • Clinical Medicine

Background:

  • Beta-blocker therapy is standard for chronic heart failure (CHF).
  • Prognostic assessment in CHF patients on beta-blockers requires refined risk stratification.
  • Cardiopulmonary exercise testing (CPET) provides valuable physiological data.

Purpose of the Study:

  • To determine the prognostic significance of traditional CPET parameters.
  • To evaluate CPET's role in predicting cardiovascular death in CHF patients treated with beta-blockers.

Main Methods:

  • Prospective follow-up of 631 CHF patients treated with beta-blockers.
  • Analysis of traditional CPET parameters including peak systolic blood pressure (SBP), peak circulatory power (CP), and exertional oscillatory ventilation (EOV).
  • Univariate and multivariable analyses to assess risk prediction for cardiovascular death.

Main Results:

  • All CPET parameters were associated with outcome at univariate analysis.
  • Hemodynamic parameters, specifically peak SBP and peak CP, showed the highest predictive value.
  • Exertional oscillatory ventilation (EOV) was detected in 7% of patients and was associated with significantly higher mortality.
  • Peak SBP emerged as the strongest independent risk index in both the overall and non-EOV populations.

Conclusions:

  • Traditional CPET parameters are informative for risk stratification in CHF patients on beta-blockers.
  • Peak SBP, peak CP, and EOV are the most predictive CPET parameters.
  • EOV enhances risk stratification, particularly in a low-risk population, though its prevalence is low.
  • Peak SBP provides significant risk evaluation beyond other CPET parameters in the majority of patients without EOV.
Abstract

More Related Videos

Assessment of Pulmonary Capillary Blood Volume, Membrane Diffusing Capacity, and Intrapulmonary Arteriovenous Anastomoses During Exercise07:09

Assessment of Pulmonary Capillary Blood Volume, Membrane Diffusing Capacity, and Intrapulmonary Arteriovenous Anastomoses During Exercise

Published on: February 20, 2017

Related Concept Videos

Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation, vasodilation, and...
Exercise and Cardiac Output01:17

Exercise and Cardiac Output

Regular physical activity is essential for maintaining cardiovascular health, with aerobic exercises being particularly effective. According to the American Heart Association, 150 minutes of moderate to intense aerobic exercise per week is recommended for a healthy heart. Aerobic activities may include brisk walking, running, bicycling, cross-country skiing, and swimming, ideally performed three to five times per week.
Sustained exercise increases the muscles' oxygen demand, which can be met...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Pathophysiology of Cardiac Performance01:29

Pathophysiology of Cardiac Performance

Typical heart performance is influenced by heart rate, rhythm, myocardial contraction, and metabolism or blood flow. The cardiac muscle exhibits distinct electrophysiological features, including pacemaker activity and calcium channel control, which play a vital role in the heart's response to various drugs. The autonomic nervous system, comprising the sympathetic and parasympathetic branches, regulates heart rate. Sympathetic activation increases heart rate, while parasympathetic activation...
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
Cardiac Output I:Effect of Heart Rate on Cardiac Output01:19

Cardiac Output I:Effect of Heart Rate on Cardiac Output

Cardiac Output
Cardiac output (CO) refers to the total amount of blood ejected by one of the ventricles in liters per minute (L/min). In a resting adult, CO ranges from 5 to 6 L/min, adjusting according to the body's metabolic requirements.
Effect of Heart Rate on Cardiac Output
Cardiac output adapts to metabolic demands during stress, physical activity, or illness. The autonomic nervous system regulates heart rate via the sinoatrial node. The parasympathetic nervous system decreases heart rate...