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Published on: October 1, 2019
[Comparative analysis between cardiopulmonary exercise testing and echocardiography in patients of heart failure with
Ya-qi Ren1, Ning-fu Wang, Hao Pan
1Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou First People's Hospital, China.
Insights
Cardiopulmonary exercise testing (CPET) demonstrates significant clinical and predictive value in assessing patients with heart failure with normal ejection fraction (HFNEF). These findings highlight CPET
Area of Science:
- Cardiology
- Exercise Physiology
Background:
- Heart failure with normal ejection fraction (HFNEF) presents unique diagnostic challenges.
- Understanding the functional capacity and prognostic indicators in HFNEF is crucial for patient management.
Purpose of the Study:
- To evaluate the clinical utility and predictive capabilities of cardiopulmonary exercise testing (CPET) in HFNEF patients.
- To correlate CPET parameters with echocardiographic findings in this population.
Main Methods:
- A cohort of 49 HFNEF patients (New York Heart Association class II) underwent CPET and ultrasonic cardiography (UCG).
- Data were collected three days post-admission.
- Pearson's and partial correlations were employed to analyze the relationship between CPET and UCG parameters.
Main Results:
- Significant correlations were observed between mitral inflow/annular velocities (E/E', E') and key CPET metrics including peak oxygen uptake (VO₂ peak), carbon dioxide production (VCO₂), and minute ventilation/carbon dioxide production (VE/VCO₂).
- Adjusted analyses confirmed the association of VCO₂ and VE/VCO₂ with E/E' and E', indicating their relevance in HFNEF.
- Specific correlations included E/E' with VO₂ peak (r = -0.287, P = 0.046) and E' with VCO₂ (r = 0.452, P = 0.001).
Conclusions:
- Cardiopulmonary exercise testing (CPET) possesses substantial assessment and prognostic value in patients with HFNEF.
- CPET parameters provide meaningful insights into the functional status and potential outcomes for HFNEF patients.
Objective:
To assess the clinical and predictive value of cardiopulmonary exercise testing (CPET) used in heart failure with normal left ventricular ejection fraction (HFNEF).
Methods:
A total of 49 HFNEF patients of (New York Heart Association) NYHA class II were randomly selected from September 2010 to July 2012. The parameters of CPET and ultrasonic cardiogram (UCG) were collected at Day 3 post-admission. Person's and partial correlations were used to perform to compare CPET and UCG.
Results:
Pearson's correlation revealed that mitral peak velocity of early filling/early diastolic mitral annular velocity (E/E', 10.14 ± 2.05) was significantly correlated with peak oxygen uptake (VO₂ peak, (24.15 ± 8.31) ml×kg⁻¹×min⁻¹, r = -0.287, P = 0.046), carbon dioxide production (VCO₂, (1.63 ± 0.51) L/min, r = -0.429, P = 0.002), partial pressure of end-tidal carbon dioxide (PET CO₂, (39.50 ± 7.77) mm Hg, r = -0.282, P = 0.050) and minute ventilation/carbon dioxide production (VE/VCO₂, 31.69 ± 5.32, r = 0.411, P = 0.003). Early diastolic mitral annular velocity (E', (6.46 ± 1.60) cm/s) was relevant to VO₂ peak (r = 0.351, P = 0.013), VCO(2) (r = 0.452, P = 0.001), PET CO₂ (r = 0.310, P = 0.030), VE/VCO₂ (r = -0.434, P = 0.002) and respiratory exchange ratio (RER, 1.18 ± 0.13, r = 0.350, P = 0.014). After adjustment, VCO₂ was correlated with E/E' (r = -0.369, P = 0.019) and E' (r = 0.393, P = 0.010). VE/VCO₂ was relevant to E/E' (r = 0.414, P = 0.006) and E' (r = -0.334, P = 0.031).
Conclusion:
For HFNFE patients, CPET has high values of assessment and prognosis.
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