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Exercise testing in chronic heart failure

By Scott Bowen, Secondary Prevention and Rehabilitation Section

Prevention
Risk Factors and Prevention


Introduction

We all know that one major symptom experienced by many patients with chronic heart failure (CHF) is exercise intolerance, also commonly referred to as one’s exercise capacity. But what does this mean, how do we measure it, and just how important is this?

Typically, it is important to consider multiple physiological variables, including pulmonary oxygen uptake (VO2), heart rate (HR), and stroke volume, as well as considering the role of both central and peripheral organs in determining exercise tolerance.

Test your knowledge

 

Note: The views and opinions expressed on this page are those of the author and may not be accepted by others. While every attempt is made to keep the information up to date, there is always going to be a lag in updating information. The reader is encouraged to read this in conjunction with appropriate ESC Guidelines. The material on this page is for educational purposes and is not for use as a definitive management strategy in the care of patients. Quiz material on the site are only examples and do not guarantee outcomes from formal examinations.

 

References

Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. N Engl J Med. Exercise capacity and mortality among men referred for exercise testing. 2002. 346(11):793-801.

Bowen TS, Cannon DT, Begg G, Baliga V, Witte KK, Rossiter HB. A novel cardiopulmonary exercise test protocol and criterion to determine maximal oxygen uptake in chronic heart failure. J Appl Physiol. 2012. 113(3):451-8.

Hill AV, Lupton H. Muscular exercise, lactic acid, and the supply and utilization of oxygen. Q J Med. 1923. 16:135–171

Poole DC, Richardson RS, Haykowsky MJ, Hirai DM, Musch TI. Exercise limitations in heart failure with reduced and preserved ejection fraction. J Appl Physiol. 2018. 124(1):208-224.