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Cardiopulmonary exercise testing criteria for advanced therapies in patients with heart failure

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Abstract

Many cardiology associations endorse the role of the cardiopulmonary exercise test (CPET) to define the severity of impairment of functional capacity in individuals with heart failure with reduced ejection fraction (HFrEF) and when evaluating the need for advanced therapies for these patients. The focus of the CPET within the cardiology community has been on peak volume of oxygen uptake (VO2). However, several CPET variables are associated with outcomes in individuals with and without chronic disease and can inform clinical decisions in individuals with HFrEF. In this manuscript, we will review the normal cardiopulmonary response to a graded exercise test and review current guideline recommendations relative to CPET in patients with HFrEF.

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Funding

CA Brawner: Dr. Brawner is supported by the following grants from the National Institutes of Health: 1R01AG077179-01 and R33HL143099.

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Henry Ford Hospital, 6525 Second Ave., Detroit, MI, 48202, USA

    Clinton A. Brawner

  2. Division of Pulmonary & Critical Care Medicine, Henry Ford Hospital, 2799 West Grand Blvd Suite K17, Detroit, MI, 48202, USA

    Michael H. Lazar

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Both authors contributed to the writing of this manuscript.

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Correspondence to Clinton A. Brawner.

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Competing interests

CA Brawner: Dr. Brawner has served as a Project Director for exercise testing core laboratory service with service agreements with Actelion Pharmaceuticals, Bristol Myers Squibb, Medpace, and Labcorp. Payment for these services is made to Henry Ford Health System. MH Lazar: No conflicts to disclose.

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Brawner, C.A., Lazar, M.H. Cardiopulmonary exercise testing criteria for advanced therapies in patients with heart failure. Heart Fail Rev 28, 1297–1306 (2023). https://doi.org/10.1007/s10741-023-10337-y

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