Author/Editor     Corrà, Ugo; Agostoni, Pier Giuseppe; Anker, Stefan D.; Coats, Andrew J.; Crespo-Leiro, Maria G.; Boer, Rudolph A. de; Harjola, Veli-Pekka; Hill, Loreena; Lainščak, Mitja; Lund, Lars H.
Title     Role of cardiopulmonary exercise testing in clinical stratification in heart failure
Type     članek
Vol. and No.     Letnik 20, št. 1
Publication year     2018
Volume     str. 3-15
ISSN     1388-9842 - European journal of heart failure
Language     eng
Abstract     Traditionally, the main indication for cardiopulmonary exercise testing (CPET) in heart failure (HF) was for the selection of candidates to heart transplantation: CPET was mainly performed in middle-aged male patients with HF and reduced left ventricular ejection fraction. Today, CPET is used in broader patients' populations, including women, elderly, patients with co-morbidities, those with preserved ejection fraction, or left ventricular assistance device recipients, i.e. individuals with different responses to incremental exercise and markedly different prognosis. Moreover, the diagnostic and prognostic utility of symptom-limited CPET parameters derived from submaximal tests is more and more considered, since many patients are unable to achieve maximal aerobic power. Repeated tests are also being used for risk stratification and evaluation of intervention, so that these data are now available. Finally, patients, physicians and healthcare decision makers are increasingly considering how treatments might impact morbidity and quality of life rather than focusing more exclusively on hard endpoints (such as mortality) as was often the case in the past. Innovative prognostic flowcharts, with CPET at their core, that help optimize risk stratification and the selection of management options in HF patients, have been developed.
Keywords     testne obremenitve
srčno popuščanje
napovedi
exercise testing
heart failure
prognosis