Lowes, William Holden Hubert

Heart failure (HF) is a condition with several possible etiologies that influence patient symptomatology, including response to exercise. The purpose of this review was to assess how cardiopulmonary exercise testing (CPET) parameters used for risk stratification differ and are associated with mortality and adverse cardiac events in patients with different HF etiologies. We completed a systematic review of studies that assessed CPET data in adult heart failure patients and reported outcomes of mortality, left ventricular assist device implantation, heart transplantation, or hospitalization. Interestingly, the optimal threshold values derived from CPET were strikingly similar for stratifying risk in patients with different HF etiologies. Even with heterogeneity in the data, the literature suggests that optimal threshold values from CPET can be applied generally without consideration of HF etiology. However, there is a need to consider a broader spectrum of HF etiologies and CPET parameters in larger and more representative study populations.

Author Keywords: Cardiopulmonary Exercise Testing, Etiology, Heart Failure, Ischemic Cardiomyopathy, Non-Ischemic Cardiomyopathy, Prognosis