Exercise intolerance in heart failure: update on exercise parameters for diagnosis, prognosis and therapeutic interventions. [Review]

Pardaens S; Calders P; Derom E; De Sutter J.

Acta Cardiologica. 68(5):495-504, 2013 Oct.

Exercise intolerance is a hallmark feature of chronic heart failure and is
associated with poor prognosis. This review provides an update on
cardiopulmonary exercise variables, proven to be prognostically important
in heart failure. Besides the widely accepted peak oxygen consumption
(peak VO2) and VEN/VCO2 slope, other exercise variables – exercise
oscillatory ventilation (EOV) and partial pressure of end-tidal CO2,
(PETCO2) – should gain attention in the interpretation of cardiopulmonary
exercise testing. In addition to prognosis, the pathophysiological origin
is also discussed. Different mechanisms underlie these exercise variables
with an important contribution of haemodynamic, pulmonary and peripheral
abnormalities. Given the different pathophysiological origin, a
multivariate assessment with the inclusion of all the aforementioned
parameters should be encouraged, not only for diagnostic and prognostic
purposes but also for evaluating the effect of interventions.