Short-term reproducibility of cardiopulmonary measurements during exercise testing in patients with severe chronic heart failure |
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| Affiliation: | 1. Division of Cardiology, Children''s National Health System and Department of Pediatrics George Washington University School of Medicine and Health Sciences, Washington, DC;2. Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine University of Pennsylvania, Philadelphia, PA;3. Division of Cardiology, The Children''s Hospital of Philadelphia and Department of Pediatrics Perelman School of Medicine University of Pennsylvania, Philadelphia, PA;1. Division of Cardiology, Children''s National Health System and Department of Pediatrics, George Washington University School of Health Sciences, Washington, DC, USA;2. Mid America Heart Institute St. Luke''s Health System, Kansas City, MO, USA;3. Division of Cardiology, The Children''s Hospital of Philadelphia and Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA;4. Center for Pediatric Clinical Effectiveness, Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA, USA;1. Biomechanics Laboratories, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA;2. Sports Medicine Center, Mayo Clinic, Rochester and Minneapolis, MN, USA;3. Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN, USA;4. Department of Physical Medicine & Rehabilitation, Mayo Clinic, Rochester, MN, USA |
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| Abstract: | Eleven men with severe chronic heart failure (peak cardiac index 4.0 ± 0.2 L/m 2 /min), six on a heart transplantation waiting list, were prospectively assessed. To determine reproducibility of cardiopulmonary and hemodynamic variables for clinical purposes during ramp bicycle ergometry, the patients underwent two ramp bicycle ergometer tests (3 minutes unloaded, work rate increments of 12.5 W/min) with a 1-week interval between tests. Oxygen uptake (v̇ O 2 ) carbon dioxide production (v̇ CO 2 ), and ventilation were measured breath by breath, and calculations were performed to determine gas exchange ratio, oxygen pulse, ventilatory equivalents of oxygen and carbon dioxide, and end-tidal partial pressure for oxygen and carbon dioxide. Additionally, heart rate, blood pressure, and lactate levels were assessed. Measurements were performed at submaximum work rate levels of 25 W, 50 W, and 75 W at ventilatory threshold and at peak work rate. At all measurement points, the coefficient of variation for cardiopulmonary variables was between 1.4% and 7.1% for submaximum work rate levels, between 1.2% and 4.4% at ventilatory threshold, and between 2.4% and 7.1% at peak work rate. For heart rate, blood pressure, and lactate levels, coefficient of variation was between 2.7% and 5.7% for submaximum work rate levels, between 1.4% and 6.1% at ventilatory threshold, and between 1.2% and 5.5% at peak work rate. The data suggest high reproducibility for duplicate measurements of cardiopulmonary and hemodynamic variables during ramp bicycle ergometry in patients with severe chronic heart failure. The results may be used to determine whether any variable in a single patient is significantly different from that obtained in a previous exercise test or if the change is within experimental error. (Am Heart J 1997;134: 20-6.) |
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