PMID- 17667032
OWN - NLM
STAT- MEDLINE
DCOM- 20070921
LR  - 20191210
IS  - 1558-2027 (Print)
IS  - 1558-2027 (Linking)
VI  - 8
IP  - 8
DP  - 2007 Aug
TI  - The cardiopulmonary exercise test is safe and reliable in elderly patients with 
      chronic heart failure.
PG  - 608-12
AB  - AIM: To assess safety and feasibility of cardiopulmonary exercise test (CPX) in 
      elderly patients with chronic heart failure (CHF) and left ventricular 
      dysfunction. METHODS AND RESULTS: We analysed 395 cardiopulmonary exercise tests 
      (CPXs) performed in 227 clinically stable patients with CHF [mean age 76 years, 
      males 70%, mean New York Heart Association (NYHA) class 2.2 +/- 0.5] and impaired 
      left ventricular function (mean ejection fraction 43 +/- 12%). Ninety-eight out 
      of 395 CPXs (25%) were performed in patients older than 80 years. A standard 
      bicycle exercise ramp protocol was used, with increments of 10 W/min. An 
      expiratory exchange ratio (RER) >or= 1.05 at the peak of CPX was considered as 
      the index of maximal exercise. Average workload was 65 +/- 23 W. No adverse 
      reactions were observed, although one test was stopped for non-sustained 
      ventricular tachycardia. The main reasons for stopping were exhaustion (50%), 
      dyspnoea (30%), maximal predicted heart rate (17%), orthopaedic problems (2.5%) 
      and significant ST segment depression (0.5%). In the overall cohort, 80% of 
      patients achieved an RER >or= 1.05 and, in 56% of them, the RER was >or= 1.15. 
      The anaerobic threshold (AT) was detectable in 80% of CPXs, and mean oxygen 
      consumption (VO2) at AT was 9 +/- 6 ml/kg per min, whereas mean peak VO2 was 11 
      +/- 3 ml/kg per min. In the cohort of patients aged > 80 years, 71% reached an 
      RER >or= 1.05 and 47% reached an RER >or= 1.15. In these older patients, AT was 
      detectable in 68% of CPXs performed, and the mean peak VO2 was 10 +/- 3 ml/kg per 
      min. CONCLUSIONS: In elderly patients with CHF, the CPX is safe, feasible and 
      able to provide basic information for individual risk assessment. These findings 
      potentially extend the indications of CPX, which is currently applied to selected 
      middle-aged patients with CHF, to the elderly population.
FAU - Scardovi, Angela Beatrice
AU  - Scardovi AB
AD  - Cardiology, S. Spirito Hospital, Rome, Italy. ab.scardovi@libero.it
FAU - Coletta, Claudio
AU  - Coletta C
FAU - De Maria, Renata
AU  - De Maria R
FAU - Perna, Silvia
AU  - Perna S
FAU - Aspromonte, Nadia
AU  - Aspromonte N
FAU - Feola, Marina
AU  - Feola M
FAU - Rosso, Gianluca
AU  - Rosso G
FAU - Greggi, Manuela
AU  - Greggi M
FAU - Ceci, Vincenzo
AU  - Ceci V
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - United States
TA  - J Cardiovasc Med (Hagerstown)
JT  - Journal of cardiovascular medicine (Hagerstown, Md.)
JID - 101259752
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Anaerobic Threshold
MH  - Chronic Disease
MH  - *Exercise Test/adverse effects
MH  - Feasibility Studies
MH  - Female
MH  - Heart Failure/*diagnosis/physiopathology
MH  - Humans
MH  - Male
MH  - Odds Ratio
MH  - Oxygen Consumption
MH  - Prognosis
MH  - Reproducibility of Results
MH  - *Respiratory Function Tests
MH  - Respiratory Mechanics
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Stroke Volume
MH  - *Ventricular Function, Left
EDAT- 2007/08/02 09:00
MHDA- 2007/09/22 09:00
CRDT- 2007/08/02 09:00
PHST- 2007/08/02 09:00 [pubmed]
PHST- 2007/09/22 09:00 [medline]
PHST- 2007/08/02 09:00 [entrez]
AID - 01244665-200708000-00009 [pii]
AID - 10.2459/01.JCM.0000281698.53983.4e [doi]
PST - ppublish
SO  - J Cardiovasc Med (Hagerstown). 2007 Aug;8(8):608-12. doi: 
      10.2459/01.JCM.0000281698.53983.4e.