Cardiac and peripheral responses to exercise in patients with chronic heart failure

Patients with chronic heart failure have a reduced physical capacity that can be characterized by the reduction in oxygen consumption at peak exercise (VO2max) . In recent years, there has been a considerable improvement in the understanding of the cardiac and peripheral responses to exercise in these patients. The role of abnormalities of the diastolic function of the left ventricule and of the periphery has been recognized. In the present article, we will try to review the main determinants of the cardiac and peripheral responses to exercise in these patients. For reasons of clarity, we shall focus on the problems of patients: (1) with chronic heart failure due to left ventricular systolic dysfunction; (2) due to non-ischaemic dilated myocardiopathy; and (3) following dynamic exercise in the upright position. The determinants of the ventilatory response, extensively studied in recent years, will not be addressed.