(Circulation. 2000;101:1080.)
© 2000 American Heart Association, Inc.
Editorial |
Peak 
O2
A Simple yet Enduring Standard
From the Divisions of Circulatory Physiology and Cardiology, Columbia Presbyterian Medical Center, New York (D.M.); the Albert Einstein College of Medicine, Bronx, New York (T.J.); and the University of Michigan, Ann Arbor (K.A.).
Correspondence to Donna Mancini, MD, 622 West 168th St, Ph-14 West, New York, NY 10032. E-mail dmm31@columbia.edu
Key Words: exercise • heart failure • prognosis • transplantation
In this issue of Circulation, Pardaens et
al1 examine the prognostic value of
cardiopulmonary exercise testing in ambulatory patients with
heart failure who are screened for cardiac transplantation. The
investigators failed to demonstrate any significant advantage of
ventilatory data over peak oxygen uptake
(O2). Over the past 10 years,
several investigators have attempted to refine the use of peak
O2 to improve its prognostic
yield. Others have sought methods or equations to estimate peak
O2 from submaximal data, such
as that collected from 6-minute walk tests or during low-level
exercise. Most investigators have concluded that the straightforward
measurement of peak O2
provides the best index of prognosis in patients with ambulatory heart
failure.
The measurement of oxygen consumption
(O2) in patients with heart
failure was first described by Weber et al2 as a
noninvasive method for characterizing cardiac reserve and functional
status in these patients. Its use as a prognostic tool has evolved.
Szlachcic et al3 initially described the prognostic use of
peak O2 in a group of 27
patients. The 1-year mortality rate was 77% for patients with a peak
O2<10 mL ·
kg-1 · min-1 and
21% for those with a peak O2
of 10 to 18 mL · kg-1 ·
min-1. Likoff et al4 reported a
36% mortality rate in 201 patients with heart failure who had a peak
O2
13 mL ·
kg-1 · min-1; the
mortality rate was 15% when peak
O2 exceeded 13 mL ·
kg-1
This article has been cited by other articles:
 |
|
 |
|
  A. Mezzani, U. Corra, C. Andriani, A. Giordano, R. Colombo, and P. Giannuzzi Anaerobic and aerobic relative contribution to total energy release during supramaximal effort in patients with left ventricular dysfunction J Appl Physiol, January 1, 2008; 104(1): 97 - 102. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. A. Jankowska, T. Witkowski, B. Ponikowska, K. Reczuch, L. Borodulin-Nadzieja, S. D. Anker, M. F. Piepoli, W. Banasiak, and P. Ponikowski Excessive ventilation during early phase of exercise: A new predictor of poor long-term outcome in patients with chronic heart failure Eur J Heart Fail, October 1, 2007; 9(10): 1024 - 1031. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. S. Gardner, K. S. Chong, J. J. Morton, and T. A. McDonagh A change in N-terminal pro-brain natriuretic peptide is predictive of outcome in patients with advanced heart failure Eur J Heart Fail, March 1, 2007; 9(3): 266 - 271. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Habedank, R. Ewert, M. Hummel, R. Wensel, R. Hetzer, and S. D. Anker Changes in exercise capacity, ventilation, and body weight following heart transplantation Eur J Heart Fail, March 1, 2007; 9(3): 310 - 316. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. G. Koch, L. Li, M. Lauer, J. Sabik, N. J. Starr, and E. H. Blackstone Effect of Functional Health-Related Quality of Life on Long-Term Survival After Cardiac Surgery Circulation, February 13, 2007; 115(6): 692 - 699. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W Doehner and S D Anker Xanthine oxidase inhibition for chronic heart failure: is allopurinol the next therapeutic advance in heart failure? Heart, June 1, 2005; 91(6): 707 - 709. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U. Corra, A. Mezzani, E. Bosimini, and P. Giannuzzi Cardiopulmonary Exercise Testing and Prognosis in Chronic Heart Failure*: A Prognosticating Algorithm for the Individual Patient Chest, September 1, 2004; 126(3): 942 - 950. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. L. Dries, R. J. Verdino, and R. C. Kowal Postexercise severe ventricular ectopy in heart failure patients: New marker for aggregate risk J. Am. Coll. Cardiol., August 18, 2004; 44(4): 827 - 828. [Full Text] [PDF]
|
|
|
|
 |
|
 M Burch and P Aurora Current status of paediatric heart, lung, and heart-lung transplantation Arch. Dis. Child., April 1, 2004; 89(4): 386 - 389. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. S. Poston and B. P. Griffith Heart Transplantation J Intensive Care Med, January 1, 2004; 19(1): 3 - 12. [Abstract] [PDF]
|
|
|
|
|
|
P. Agostoni, G. Cattadori, M. Bianchi, and K. Wasserman Exercise-Induced Pulmonary Edema in Heart Failure Circulation, November 25, 2003; 108(21): 2666 - 2671. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R.S. Gardner, F. Ozalp, A.J. Murday, S.D. Robb, and T.A. McDonagh N-terminal pro-brain natriuretic peptide: A new gold standard in predicting mortality in patients with advanced heart failure Eur. Heart J., October 1, 2003; 24(19): 1735 - 1743. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Nohria, S. W. Tsang, J. C. Fang, E. F. Lewis, J. A. Jarcho, G. H. Mudge, and L. W. Stevenson Clinical assessment identifies hemodynamic profiles that predict outcomes in patients admitted with heart failure J. Am. Coll. Cardiol., May 21, 2003; 41(10): 1797 - 1804. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Arzt, M. Harth, A. Luchner, F. Muders, S. R. Holmer, F. C. Blumberg, G. A.J. Riegger, and M. Pfeifer Enhanced Ventilatory Response to Exercise in Patients With Chronic Heart Failure and Central Sleep Apnea Circulation, April 22, 2003; 107(15): 1998 - 2003. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. D. Anker, W. Doehner, M. Rauchhaus, R. Sharma, D. Francis, C. Knosalla, C. H. Davos, M. Cicoira, W. Shamim, M. Kemp, et al. Uric Acid and Survival in Chronic Heart Failure: Validation and Application in Metabolic, Functional, and Hemodynamic Staging Circulation, April 22, 2003; 107(15): 1991 - 1997. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Koike, N. Shimizu, A. Tajima, T. Aizawa, L. T. Fu, H. Watanabe, and H. Itoh Relation Between Oscillatory Ventilation at Rest Before Cardiopulmonary Exercise Testing and Prognosis in Patients With Left Ventricular Dysfunction Chest, February 1, 2003; 123(2): 372 - 379. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Scharf, T. Merz, W. Kiowski, E. Oechslin, C. Schalcher, and H. P. Brunner-La Rocca Noninvasive Assessment of Cardiac Pumping Capacity During Exercise Predicts Prognosis in Patients With Congestive Heart Failure Chest, October 1, 2002; 122(4): 1333 - 1339. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Kruger, J.u. Graf, D. Kunz, T. Stickel, P. Hanrath, and U. Janssens brain natriuretic peptide levels predict functional capacity in patients with chronic heart failure J. Am. Coll. Cardiol., August 21, 2002; 40(4): 718 - 722. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P.R. Kalra, P.P. Ponikowski, and S.D. Anker Sympathetic activation and malignant ventricular arrhythmias: a molecular link? Eur. Heart J., July 2, 2002; 23(14): 1078 - 1080. [Full Text] [PDF]
|
|
|
|
|
|
A. Koike, H. Itoh, M. Kato, H. Sawada, T. Aizawa, L. T. Fu, and H. Watanabe Prognostic Power of Ventilatory Responses During Submaximal Exercise in Patients With Chronic Heart Disease* Chest, May 1, 2002; 121(5): 1581 - 1588. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D BIRNIE, L P SOUCIE, S SMITH, and A S L TANG Effects of cardiac resynchronisation on maximal and submaximal exercise performance in advanced heart failure patients with conduction abnormality Heart, December 1, 2001; 86(6): 703 - 704. [Full Text]
|
|
|
|
|
|
M. de Lorgeril, P. Salen, M. Accominotti, M. Cadau, J.-P. Steghens, F. Boucher, and J. de Leiris Dietary and blood antioxidants in patients with chronic heart failure. Insights into the potential importance of selenium in heart failure Eur J Heart Fail, December 1, 2001; 3(6): 661 - 669. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M E Lewis, C Newall, J N Townend, S L Hill, and R S Bonser Incremental shuttle walk test in the assessment of patients for heart transplantation Heart, August 1, 2001; 86(2): 183 - 187. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D K Satchithananda, S C Stoica, J Parameshwar, S R Large, J Wallwork, L D Sharples, G. A MacGowan, S. Murali, R. J MacFadyen, M. C Deng, et al. Effect of receiving a heart transplant BMJ, May 12, 2001; 322(7295): 1179a - 1179. [Full Text]
|
|
|
|
|
|
R. Sharma and S.D. Anker The 6-minute walk test and prognosis in chronic heart failure -- the available evidence Eur. Heart J., March 2, 2001; 22(6): 445 - 448. [PDF]
|
|