Peak exercise oxygen consumption (peak VO2) is widely accepted as a prognostic marker and an indicator for cardiac transplantation
candidacy.
1
Peak VO2 is also an important component of the Heart Failure Survival Score
- Hunt S.A.
- Abraham W.T.
- Chin M.H.
- et al.
2009 Focused update incorporated into the ACC/AHA 2005 guidelines for the diagnosis
and management of heart failure in adults: a report of the American College of Cardiology
Foundation/American Heart Association Task Force on practice guidelines developed
in collaboration with the International Society for Heart and Lung Transplantation.
J Am Coll Cardiol. 2009; 53: e1-e90
2
(HFSS), which also includes ischemic etiology, resting heart rate, ejection fraction,
mean blood pressure, intraventricular conduction delay and serum sodium in the calculation
of a numerical score and a corresponding risk stratum. Ventilatory efficiency, expressed
as the relationship between ventilation and carbon dioxide production during graded
exercise (VE/VCO2 slope), may be prognostically superior to peak VO2.
3
Despite its predictive ability, VE/VCO2 slope is commonly not addressed or is given a subservient role to peak VO2. The 2006 listing criteria of the International Society of Heart and Lung Transplantation
4
(ISHLT) do consider VE/VCO2 slope as a listing criteria in patients with sub-maximal exercise tests, but more
recent guidelines
1
ignore ventilatory efficiency.
- Hunt S.A.
- Abraham W.T.
- Chin M.H.
- et al.
2009 Focused update incorporated into the ACC/AHA 2005 guidelines for the diagnosis
and management of heart failure in adults: a report of the American College of Cardiology
Foundation/American Heart Association Task Force on practice guidelines developed
in collaboration with the International Society for Heart and Lung Transplantation.
J Am Coll Cardiol. 2009; 53: e1-e90
1
Furthermore, there are no common multivariate prognostic tools
- Hunt S.A.
- Abraham W.T.
- Chin M.H.
- et al.
2009 Focused update incorporated into the ACC/AHA 2005 guidelines for the diagnosis
and management of heart failure in adults: a report of the American College of Cardiology
Foundation/American Heart Association Task Force on practice guidelines developed
in collaboration with the International Society for Heart and Lung Transplantation.
J Am Coll Cardiol. 2009; 53: e1-e90
3
that consider ventilatory efficiency despite its documented prognostic strength.
3
Therefore, we investigated the prognostic effect of VE/VCO2 slope and hypothesized that it would add predictive information to the HFSS.To read this article in full you will need to make a payment
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References
- 2009 Focused update incorporated into the ACC/AHA 2005 guidelines for the diagnosis and management of heart failure in adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines developed in collaboration with the International Society for Heart and Lung Transplantation.J Am Coll Cardiol. 2009; 53: e1-e90
- Development and prospective validation of a clinical index to predict survival in ambulatory patients referred for cardiac transplant evaluation.Circulation. 1997; 95: 2660-2667
- The clinical and research applications of aerobic capacity and ventilatory efficiency in heart failure: an evidence-based review.Heart Fail Rev. 2008; 13: 245-269
- Listing criteria for heart transplantation: International Society for Heart and Lung Transplantation guidelines for the care of cardiac transplant candidates—2006.J Heart Lung Transplant. 2006; 25: 1024-1042
- Determining the best ventilatory efficiency measure to predict mortality in patients with heart failure.J Heart Lung Transplant. 2006; 25: 589-595
Article info
Publication history
Published online: December 21, 2009
Identification
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© 2010 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
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- Listing Criteria for Heart Transplantation: International Society for Heart and Lung Transplantation Guidelines for the Care of Cardiac Transplant Candidates—2006The Journal of Heart and Lung TransplantationVol. 25Issue 9
- PreviewTwo of the previous International Society for Heart and Lung Transplantation (ISHLT) consensus conferences have addressed listing criteria for patients awaiting heart transplantation.1,2 Guidelines from these two conferences were completed before the acceptance of β-blocker and device therapies in the clinical treatment of late-stage heart failure. Guidelines addressing the management of heart failure are now available from the European Society of Cardiology (ESC) as well as the American College of Cardiology (ACC), American Heart Association (AHA) and Heart Failure Society of America (HFSA) in the USA; however, these statements are not comprehensive regarding the criteria for listing patients for heart transplantation.
- Full-Text
- Preview
- Determining the Best Ventilatory Efficiency Measure to Predict Mortality in Patients with Heart FailureThe Journal of Heart and Lung TransplantationVol. 25Issue 5
- PreviewVentilatory efficiency, the relationship between ventilation (VE) and carbon dioxide production (VCO2), predicts mortality in heart failure patients, but its determination has not been standardized. Additionally, it is unclear if the prognostic power of ventilatory efficiency is independent of exercise intensity. Therefore, we investigated the relative prognostic power of different measures of ventilatory efficiency calculated from maximal and sub-maximal exercise in patients with heart failure.
- Full-Text
- Preview
