Reduced Confounding by Impaired Ventilatory Function With Oxygen Uptake Efficiency Slope and VE/VCO2 Slope Rather Than Peak Oxygen Consumption to Assess Exercise Physiology in Suspected Heart Failure

Barron, Anthony J., Medlow, Katharine I., Giannoni, Alberto, Unsworth, Beth, Coats, Andrew J. S., Mayet, Jamil, Howard, Luke S. and Francis, Darrel P. (2010) Reduced Confounding by Impaired Ventilatory Function With Oxygen Uptake Efficiency Slope and VE/VCO2 Slope Rather Than Peak Oxygen Consumption to Assess Exercise Physiology in Suspected Heart Failure. Congestive Heart Failure, 16 (6). pp. 259-264. ISSN 1751-7133

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Abstract

Heart failure and ventilatory disease often coexist; both create abnormalities in cardiopulmonary exercise test measurements. The authors evaluated the relative dependency of a well-recognized index of heart failure, peak oxygen consumption (VO(2)), and 2 newer indices, the minute ventilation (VE)/carbon dioxide production (VCO(2)) slope and oxygen uptake efficiency slope (OUES), on standard markers of impaired cardiac and ventilatory function. One hundred twenty-four patients (median age, 65.8; range, 22.6-84.9), with functional limitation from clinical heart failure were exercised. Peak VO(2) was 17.14 ± 7.58 mL/kg/min, VE/VCO(2) slope 50.1 ± 20.1, OUES 1.46 ± 0.68 L/min, and forced expiratory volume in 1 second (FEV(1) ) 1.88 ± 0.75 L. Peak VO(2) is substantially more sensitive to FEV(1) than ejection fraction (4.0 mL/kg/min difference between above- and below-median FEV(1) and 1.5 mL/kg/min between above- and below-median ejection fraction). OUES does not share this peculiar excess sensitivity to FEV(1) (0.12 L/min difference between above- and below-median FEV(1) and 0.01 L/min between above- and below-median ejection fraction). VE/VCO(2) slope has a borderline effect by FEV(1) (7.07 difference between above- and below-median FEV(1) and 2.07 between above- and below-median ejection fraction). Although widely used as a marker of heart failure severity, peak VO(2) is very sensitive to spirometry status and is indeed more affected by FEV(1) than by ejection fraction. OUES in contrast does not show this preferential sensitivity to impaired FEV(1).

Item Type: Article
Faculty \ School:
Depositing User: Rhiannon Harvey
Date Deposited: 09 Jan 2012 09:20
Last Modified: 21 Apr 2020 16:57
URI: https://ueaeprints.uea.ac.uk/id/eprint/35932
DOI: 10.1111/j.1751-7133.2010.00183.x

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