Performance of Heart Failure Patients with Severely Reduced Ejection Fraction during Cardiopulmonary Exercise Testing on Treadmill and Cycle Ergometer; Similarities and Differences.

Mazaheri R; Sadeghian M; Nazarieh M; Niederseer D; Schmied C

International Journal of Environmental Research & Public Health
[Electronic Resource]. 18(24), 2021 12 08.

BACKGROUND: Peak oxygen consumption (VO2) measured by cardiopulmonary
exercise testing (CPET) is a significant predictor of mortality and future
transplantation in heart failure patients with severely reduced ejection
fraction (HFrEF). The present study evaluated the differences in peak VO2
and other prognostic variables between treadmill and cycle CPETs in these
METHODS: In this cross-over study design, thirty males with severe HFrEF
underwent CPET on both a treadmill and a cycle ergometer within 2-5 days
apart, and important CPET parameters between two exercise test modalities
were compared.
RESULTS: Peak VO2 was 23.12% higher on the treadmill than on cycle (20.55
+/- 3.3 vs. 16.69 +/- 3.01, p < 0.001, respectively). Minute ventilation
to carbon dioxide production (VE/VCO2) slope was not different between the
two CPET modes (p = 0.32). There was a strong positive correlation between
the VE/VCO2 slopes during treadmill and cycle testing (r = 0.79; p <
0.001). VE/VCO2 slope was not related to peak respiratory exchange ratio
(RER) in either modality (treadmill, r = 0.13, p = 0.48; cycle, r = 0.25,
p = 0.17). The RER level was significantly higher on the cycle ergometer
(p < 0.001).
CONCLUSION: Peak VO2 is higher on treadmill than on cycle ergometer in
severe HFrEF patients. In addition, VE/VCO2 slope is not a modality
dependent parameter and is not related to the patients’ effort during