Summary
Cardiac haemodynamics are deranged in chronic heart failure but fail to predict the exercise capacity of the patient. Cardiac power output is a descriptor of cardiac function derived from preload, blood pressure and cardiac output. Forty-one patients with moderately severe and severe chronic heart failure were exercised on a cycle ergometer to determine the relationship between traditional haemodynamics and cardiac power output and exercise capacity. Resting cardiac power output was no more predictive of exercise capacity than resting stroke-work index or resting cardiac index (r=0.53, 0.61 and 0.51 respectively). Maximum cardiac power output and the ability to increase cardiac power output, however, were correlated with exercise capacity (r=0.79 and 0.80). It is concluded that resting cardiac power output does not predict subsequent exercise capacity but that maximum cardiac power output and the ability to increase cardiac power output on stimulation are good descriptors of functional cardiac reserve.
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Bain RJI, Tan LB, Littler WA, Murray RG, Davies MK (1988) Dobutamine challenge accurately assesses functional cardiac reserve in chronic heart failure (abstract). Eur Heart J 9 [Suppl 1]:P1747
Bayliss J, Norell M, Canepa-Anson R, Sutton G, Poole-Wilson PA (1987) Untreated heart failure: clinical and neuroendocrine effects of introducing diuretics. Br Heart J 57:17–22
Benje W, Litchfield RL, Marcus ML (1980) Exercise capacity in patients with severe left ventricular dysfunction. Circulation 61:955–959
Buller NP, Poole-Wilson PA (1988) Extrapolated maximal oxygen consumption: a new method for the objective analysis of respiratory gas exchange during exercise. Br Heart J 59:212–217
Cohn JN, Francis GS (1982) Problems in clinical evaluation. In: Braunwald E, Mock MB, Watson J (eds) Congestive heart failur: current research and clinical applications. Grune and Stratton, New York, pp 367–376
Criteria Committee of the New York Heart Association (1973) Nomenclature and criteria for diagnosis of diseases of the heart and great vessels, 7th edn. Little, Brown, Boston, p 286
Eichna LW (1960) Circulatory congestion and heart failure. Calculation 22:864–886
Engler R, Ray R, Higgins C, McNally C, Buxton WH, Bhargava V, Shabetai R (1982) Clinical assessment and follow-up of functional capacity in patients with chronic congestive cardiomyopathy. Am J Cardiol 49:1832–1837
Forrester IS, Ganz W, Diamond G, McHugh T, Chonette DW, Swan HJC (1972) Thermodilution cardiac output determination with a single-flow directed catheter. Am Heart J 83:306–311
Franciosa JA, Park M, Levine B (1981) Lack of correlation between exercise capacity and indices of left ventricular performance in heart failure. Am J Cardiol 47:33–39
Francis GS (1986) Clinical aspects of heart failure. Curr Opin Cardiol 1:347–353
Francis GS, Siegel RM, Goldsmith SR, Olivari MT, Levine B, Cohn JN (1985) Acute vasoconstrictor response to intravenous furosemide in patients with chronic congestive heart failure. Activation of neurohumoral axis. Ann Intern Med 103:1–6
Gelberg III, Rubin SA, Ports TA, Brundage H, Parmley WW, Charterjee K (1979) Detection of left ventricular functional reserve by supine exercise haemodynamics in patients with severe, chronic heart failure. Am J Cardiol 44:1062–1067
Higginbotham MD, Morris KG, Conn EH, Coleman RE, Cobb FR (1983) Determinants of variable exercise performance among patients with severe left ventricular dysfunction. Am J Cardiol 51:52–64
Janicki JS, Shroff SG, Weber KT (1986) Instrumentation for monitoring respiratory gas exchange. In: Weber KT, Janicki JS (eds) Cardiopulmonary exercise testing: physiologic principles and clinical applications. Saunders, Toronto, pp 113–137
Lipkin DP, Perrins J, Poole-Wilson PA (1985) Respiratory gas exchange in the assessment of patients with impaired ventricular function. Br Heart J 84:34–38
Naimark A, Wasserman K, Mcllroy MB (1964) Continuous measurement of ventilating exchange ratio during exercise. J Appl Physiol 19:644–652
Tan LB (1987) Cardiac pumping capacity and prognosis in heart failure. Lancet 11:1360–1363
Tan LB, Bain RJI, Littler WA (1989) Assessing cardiac pumping capability by exercise testing and inotropic stimulation. Br Heart J 62:20–25
Tristani FE, Hughes CV, Archibald DG, Sheldahl LM, Cohn JN, Fletcher R (1987) Safety of graded symptom-linked exercise testing in patients with congestive heart failure. Circulation 76 [Suppl VI]:54–58
Weber KT, Wilson JR, Janicki JS, Likoff MJ (1984) Exercise testing in the evaluation of the patient with chronic cardiac failure. Am Rev Respir Dis 129: S60-S62
Weiner DA (1983) Evaluating the conditions of patients with congestive heart failure by exercise testing. Arch Intern Med 143:1978–1980
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Bain, R.J.I., Bun Tan, L., Gordon Murray, R. et al. The correlation of cardiac power output to exercise capacity in chronic heart failure. Eur J Appl Physiol 61, 112–118 (1990). https://doi.org/10.1007/BF00236703
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DOI: https://doi.org/10.1007/BF00236703