Blood Pressure Response during Cardiopulmonary Exercise Testing in Heart Failure

AbstractIntroductionThe prognostic value of peak VO2 and VE/VCO2 slope measured during cardiopulmonary exercise (CPX) testing has been well established in patients with advanced heart failure, but blood pressure response to exercise is less well characterized.MethodsWe retrospectively studied 151 outpatients who underwent CPX testing as part of an advanced heart failure (HF) evaluation. The outcome of interest was failure of medical management, defined by death, cardiac transplantation, or left ventricular assist device placement. Patients were stratified into tertiles by change in systolic blood pressure (SBP) ( 20 mmHg were associated with an increased hazard (HR 1.046, 95% CI 1.018, 1.075).ConclusionIn conclusion, changes in SBP during CPX testing provide additional prognostic information above standard clinical variables. The peculiar increase in risk noted in those with a rise in SBP > 20 mmHg is less clear and needs to be investigated further. Introduction The prognostic value of peak VO2 and VE/VCO2 slope measured during cardiopulmonary exercise (CPX) testing has been well established in patients with advanced heart failure, but blood pressure response to exercise is less well characterized. Methods We retrospectively studied 151 outpatients who underwent CPX testing as part of an advanced heart failure (HF) evaluation. The outcome of interest was failure of medical management, defined by death, cardiac transplantation, or left ventricular assist device placement. Patients were stratified into tertiles by change in systolic blood pressure (SBP) ( 20 mmHg were associated with an increased hazard (HR 1.046, 95% CI 1.018, 1.075). Conclusion In conclusion, changes in SBP during CPX testing provide additional prognostic information above standard clinical variables. The peculiar increase in risk noted in those with a rise in SBP > 20 mmHg is less clear and needs to be investigated further. Accepted for Publication: 14 February 2018 Corresponding Author: Zachary J. Il'Giovine, MD, Duke University Medical Center, 2301 Erwin Road Durham, NC 27710, USA, Email: zachary.il.giovine@dm.duke.edu The authors attest that the results of this study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation, and statement that results of the present study do not constitute endorsement by ACSM. This manuscript was funded internally by the Duke Clinical Research Institute, Durham, NC. © 2018 American College of Sports Medicine

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