Evaluation of Maximum O2 Consumption: Using Ergo-Spirometry in Severe Heart Failure
Although sport-physiologists have repeatedly analyzed respiratory gases through exercise, it is relatively new in the cardiovascular field and is obviously more acceptable than standard exercise test, which gives only information about the existence or absence of cardiovascular diseases (CVDs). Through the new method of exercise test, parameters including aerobic and anaerobic are checked and monitored. 22 severe cases of heart failure, who were candidates of heart transplantation, referring to Massih Daneshvari Hospital in Tehran from Nov. 2007 to Nov. 2008 enrolled this study. The study was designed as a cross-sectional performance and evaluated only patients with ejection fraction less than 30%. O2 mean consumption was 6.27±4.9 ml/kg/min at rest and 9.48±3.38 at anaerobic threshold (AT) exceeding 13 ml/kg/min in maximum which was significantly more than the expected levels. Respiratory exchange ratio (RER) was over 1 for all patients. This study could not find any statistical correlations between VO2 max and participants' ergonomic factors such as age, height, weight, BMI, as well as EF. This study showed no significant correlation between VO2 max and maximum heart rate (HR max), although O2 maximum consumption was rationally correlated with expiratory ventilation. This means that the patients achieved maximum ventilation through exercise in this study, but failed to have their maximum heart rate being led probably by HF-induced brady-arrhythmia or deconditioning of skeletal muscles.
Fishman AP, Elias J, Fishman J, Grippi MA, Senior RM, Pack AI, editors. Fishman's Pulmonary Diseases and Disorders. 4th ed. New York, NY: McGraw Hill; 2008.
Vivekananthan K, Lavie CJ, Milani RV. Stress testing. In: Lavie CJ, Lubin MF, editors. Clinics Atlas of Office Procedures-Cardiovascular Disease. Philadelphia, PA: WB Saunders; 2000. p. 377-91.
Milani RV, Lavie CJ, Spiva H. Limitations of estimating metabolic equivalents in exercise assessment in patients with coronary artery disease. Am J Cardiol 1995;75(14):940-2.
Milani RV, Lavie CJ, Mehra MR. Cardiopulmonary exercise testing: how do we differentiate the cause of dyspnea? Circulation 2004;110(4):e27-31.
Brooks GA. Anaerobic threshold: review of the concept and directions for future research. Med Sci Sports Exerc 1985;17(1):22-34.
Simonton CA, Higginbotham MB, Cobb FR. The ventilatory threshold: quantitative analysis of reproducibility and relation to arterial lactate concentration in normal subjects and in patients with chronic congestive heart failure. Am J Cardiol 1988;62(1):100-7.
Neuberg GW, Friedman SH, Weiss MB, Herman MV. Cardiopulmonary exercise testing. The clinical value of gas exchange data. Arch Intern Med 1988;148(10):2221-6.
Fleg JL, Piña IL, Balady GJ, Chaitman BR, Fletcher B, Lavie C, Limacher MC, Stein RA, Williams M, Bazzarre T. Assessment of functional capacity in clinical and research applications: An advisory from the Committee on Exercise, Rehabilitation, and Prevention, Council on Clinical Cardiology, American Heart Association. Circulation 2000;102(13):1591-7.
Matsumura N, Nishijima H, Kojima S, Hashimoto F, Minami M, Yasuda H. Determination of anaerobic threshold for assessment of functional state in patients with chronic heart failure. Circulation 1983;68(2):360-7.
Davis JA. Anaerobic threshold: review of the concept and directions for future research. Med Sci Sports Exerc 1985;17(1):6-21.
Jennings GL, Esler MD. Circulatory regulation at rest and exercise and the functional assessment of patients with congestive heart failure. Circulation 1990;81(1 Suppl):II5-13.
Older P, Hall A, Hader R. Cardiopulmonary exercise testing as a screening test for perioperative management of major surgery in the elderly. Chest 1999;116(2):355-62.
Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF, Froelicher VF, Mark DB, McCallister BD, Mooss AN, O'Reilly MG, Winters WL Jr, Gibbons RJ, Antman EM, Alpert JS, Faxon DP, et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). Circulation 2002;106(14):1883-92.
Gibbons RJ, Balady GJ, Beasley JW, Bricker JT, Duvernoy WF, Froelicher VF, Mark DB, Marwick TH, McCallister BD, Thompson PD Jr, Winters WL, Yanowitz FG, Ritchie JL, Gibbons RJ, Cheitlin MD, et al. ACC/AHA Guidelines for Exercise Testing. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Exercise Testing). J Am Coll Cardiol 1997;30(1):260-311.
Ramos-Barbón D, Fitchett D, Gibbons WJ, Latter DA, Levy RD. Maximal exercise testing for the selection of heart transplantation candidates: limitation of peak oxygen consumption. Chest 1999;115(2):410-7.
Ingle L, Goode K, Carroll S, Sloan R, Boyes C, Cleland JG, Clark AL. Prognostic value of the VE/VCO2 slope calculated from different time intervals in patients with suspected heart failure. Int J Cardiol 2007;118(3):350-5.
|Issue||Vol 50, No 9 (2012)|
|Congestive Heart Failure Ergo-spirometry Oxygen consumption|
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