Kleber FX; Köln PJ

European Journal Of Heart Failure [Eur J Heart Fail], ISSN: 1879-0844, 2018 Apr 14;

This article refers to ‘A flattening oxygen consumption
trajectory phenotypes disease severity and poor prognosis
in patients with heart failure with reduced,mid-range, and
preserved ejection fraction’ by D. Popovic et al., published
in this issue on pages xxx.
Cardiopulmonary exercise testing (CPET) has gained major importance
in heart failure (HF) units and in the evaluation of patients for
heart transplantation (HTx) or left ventricular assist device (LVAD)
implantation. While oxygen consumption at maximal effort (peak
VO2) has been accepted even far beyond the field of cardiology,
other parameters such as ventilatory efficiency,1 end-tidal partial
pressure of carbon dioxide (PETCO2)2 and exercise oscillatory
ventilation (EOV),3 have broadened the spectrum of understanding
and measurements of HF symptoms and helped in evaluation
of prognosis. Most data are derived from patients with systolic HF
and none of these parameters have conclusively helped to specifically
characterize diastolic HF, which is currently in the focus of
efforts to understand the HF epidemic.