Cardiopulmonary exercise testing is a core assessment for patients with heart failure

Despite advances in the treatment of heart failure (HF), which have resulted in improved survival, overall prognosis continues to be poor. Given the high short-term mortality rate, it remains important to utilize assessment techniques with established prognostic value in this patient population. Ideally, a given assessment should also be able to accurately reflect disease severity, a heterogeneous phenomenon in patients with HF, and accurately reflect the magnitude of physiologic/clinical improvement following the implementation or titration of an intervention. Cardiopulmonary exercise testing (CPX) satisfies all of the aforementioned desirable assessment attributes. Peak oxygen consumption and the minute ventilation/carbon dioxide production slope are key CPX variables in assessing prognosis and gauging disease severity. Given the high value of information obtained from this procedure, CPX should be considered a core assessment in the HF population. The current review will concisely define key CPX variables and summarize their clinical applications in patients with HF.