What question did this study set out to answer?

Determine whether ramp work-rate increment and exercise duration influence cardiopulmonary exercise test parameters across varying severities of chronic heart failure.

December 16, 2004European Journal of Heart Failure

Work-Rate Affects Cardiopulmonary Exercise Test Results in Heart Failure

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Chronic heart failure (HF) (n=90). Intervention: Cardiopulmonary exercise test (CPET) ramp protocols vs. Comparison among 5, 10, and 15 min protocols. Primary outcome: Peak V(O2) (p=<0.001).

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Key result

A 5-minute cardiopulmonary exercise test ramp protocol yielded a lower peak VO2 (16.9 ml/min/kg) compared to a 10-minute protocol (18.0 ml/min/kg, p<0.001) in patients with chronic heart failure.

Key Points

Determine whether ramp work-rate increment and exercise duration influence cardiopulmonary exercise test parameters across varying severities of chronic heart failure.
Enrolled 90 chronic heart failure patients stratified into three exercise capacity groups based on initial peak oxygen uptake (>20 ml/min/kg, n=28; 15-20 ml/min/kg, n=39; <15 ml/min/kg, n=23).
Administered three subsequent ramp exercise protocols in randomized order targeting peak exercise durations of 5, 10, and 15 minutes, with mean work-rates of 22.7 ± 8.0, 11.6 ± 3.7, and 7.5 ± 2.9 W/min.
Peak oxygen uptake was significantly lower in the 5-minute test (16.9 ± 4.3 ml/min/kg) compared to both the 10-minute (18.0 ± 4.4 ml/min/kg, p < 0.001) and 15-minute tests (18.0 ± 5.4 ml/min/kg).
The 5-minute protocol produced the lowest peak heart rate, peak ventilation, and ΔVO2/Δwork-rate slope across all heart failure severity subsets.
Ventilatory efficiency (VE/VCO2 slope) and oxygen uptake at the anaerobic threshold were not significantly affected by protocol duration in any heart failure group.

Study Design

Type

RCT (n=90)

Randomization

Randomized

PICO

Population

Chronic heart failure (HF) (n=90)

Intervention / Comparator

Cardiopulmonary exercise test (CPET) ramp protocols vs Comparison among 5, 10, and 15 min protocols (Work-rate increased to reach peak exercise in 5, 10, and 15 min)

Primary Outcome

Peak V(O2), p=<0.001

Main Result

Absolute Event Rate: 16.9% vs 18%

p-value: p=<0.001

Discussion

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Implication

Shorter CPET ramp protocols may underestimate peak VO2 in chronic HF; leaves open standardization needs for clinical assessment and research comparability.

Cite This Study

Agostoni et al. (2004) conducted an RCT in Chronic heart failure (HF) (n=90). Cardiopulmonary exercise test (CPET) ramp protocols vs. Comparison among 5, 10, and 15 min protocols was evaluated on Peak V(O2) (p=<0.001). A 5-minute cardiopulmonary exercise test ramp protocol yielded a lower peak VO2 (16.9 ml/min/kg) compared to a 10-minute protocol (18.0 ml/min/kg, p<0.001) in patients with chronic heart failure.

synapsesocial.com/papers/6a08ee6127ceb0c2a2d61ee9 https://doi.org/10.1016/j.ejheart.2004.06.007

Topics

Heart failure HFrEF treatment

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Implication

Shorter CPET ramp protocols may underestimate peak VO2 in chronic HF; leaves open standardization needs for clinical assessment and research comparability.

Work-Rate Affects Cardiopulmonary Exercise Test Results in Heart Failure

Key Points

Study Design

PICO

Main Result

Discussion

Implication

Cite This Study

Topics

Work-Rate Affects Cardiopulmonary Exercise Test Results in Heart Failure

Key Points

Study Design

PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider