Resting Oxygen Consumption and Heart Failure: Importance of Measurement for Determination of Cardiac Output With the Use of the Fick Principle |
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| Institution: | 1. Division of Cardiovascular Medicine, Henry Ford, Detroit, Michigan;2. Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan;1. The UCI Sleep Disorders Center and the Division of Pulmonary and Critical Care, University of California at Irvine, Irvine, California;2. The Sleep Heart Program at the Ohio State University, Columbus, Ohio;3. Bethesda North Hospital, Cincinnati, Ohio;4. Division of Cardiovascular Medicine, The Ohio State University, Columbus, Ohio;5. University of Cincinnati College of Medicine, Cincinnati, Ohio;6. The Center for Biostatistics, The Ohio State University, Columbus, Ohio;7. The Center for Clinical and Translational Science, The Ohio State University Columbus, Ohio;8. Bethanien Hospital, Institute of Pneumology at the University of Cologne, Solingen, Germany;2. Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China;3. Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China;4. Department of Pathology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China;1. Cardiorenal Research Laboratory, Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota;2. Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina;3. Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina;4. Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio;;5. Cardiovascular Division, Brigham and Women''s Hospital, Harvard Medical School, Boston, Massachusetts;1. Department of Internal Medicine;2. Department of Bioengineering;3. Vascular Medicine Institute;4. Division of Pulmonary, Allergy and Critical Care Medicine;5. Division of Cardiology and Heart and Vascular Institute;1. Karolinska Institutet, Department of Medicine, Cardiology unit, Stockholm, Sweden;2. Karolinska University Hospital, Heart and Vascular Theme, Stockholm, Sweden;3. St Görans Hospital, Department of Cardiology, Stockholm, Sweden;4. Département de Cardiologie & CIC-IT U 804, Centre Hospitalier Universitaire de Rennes, Rennes, France;5. Clinical Investigation Center INSERM CIC-1414, Rennes, France;6. First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland |
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| Abstract: | BackgroundResting oxygen consumption (VO2) is often estimated and frequently used to guide therapeutic decisions in symptomatic heart failure (HF) patients. The relationship between resting VO2 and symptomatic HF and the accuracy of estimations of VO2 in this population are unknown.Methods and ResultsWe performed a cross-sectional study of HF patients (n = 691) and healthy control subjects (n = 77). VO2 was measured with the use of a metabolic cart, and estimated VO2 was calculated with the use of the Dehmer, LaFarge, and Bergstra formulas and the thermodilution method. The measured and estimated VO2 were compared and the potential impact of estimations determined. In the multivariable model, resting VO2 decreased with increasing New York Heart Association (NYHA) functional class in a stepwise fashion (β NYHA functional class IV vs control = ?36 mL O2/min; P < .001). Estimations of VO2 with the use of derived equations diverged from measured values, particularly for patients with NYHA functional class IV limitations. The percentage difference of measured VO2 versus estimated VO2 was >25% in 39% (n = 271), 25% (n = 170), 82% (n = 566), and 39% (n = 271) of HF patients when using the Dehmer, LaFarge, Bergstra, and thermodilution-derived estimations of VO2 respectively.ConclusionsResting VO2 decreases with increasing NYHA functional class and is lower than in control subjects. Using estimations of VO2 to calculate CO may introduce clinically important error. |
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