Congestive heart failure exercise stress testing

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Sara Zand, M.D.[2] Lakshmi Gopalakrishnan, M.B.B.S. [3] Edzel Lorraine Co, DMD, MD[4]

Overview

Exercise stress testing with an assessment of oxygen consumption is useful in assessing the functional capacity of the heart failure patient. Cardiopulmonary exercise testing is considered to optimize prescription of exercise training.

Exercise Stress Testing

Exercise stress testing is useful in measuring the functional capacity of heart failure patients. It is also helpful to assess the efficacy of congestive heart failure treatment.

2021 European Society of Cardiology Guidelines (DO NOT EDIT) [1]

Class I
" Cardiopulmonary exercise testing is recommended as a part of the evaluation for heart transplantation and /or mechanical circulatory support. (Level of Evidence: C) "
Class IIa
"Cardiopulmonary exercise testing should be considered to optimize prescription of exercise training. (Level of Evidence: C) "
" Cardiopulmonary exercise testing should be considered to identify the cause of unexplained dyspnea and/or exercise intolerance.(Level of Evidence: C) "

Exercise and Functional Capacity Testing 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) [2]

Class I
"1. In patients with HF, assessment and documentation of NYHA functional classification are recommended to determine eligibility for treatments. [3][4] (Level of Evidence: C-LD) "
"2. In selected ambulatory patients with HF, cardiopulmonary exercise testing (CPET) is recommended to determine appropriateness of advanced treatments (eg, LVAD, heart transplant). [5][6][7][8][9](Level of Evidence: C-LD) "
Class IIa
"3. In ambulatory patients with HF, performing a CPET or 6-minute walk test is reasonable to assess functional capacity. [5][6][10][11][12][13][14][15][16][17] (Level of Evidence: C-LD) "
"4. In ambulatory patients with unexplained dyspnea, CPET is reasonable to evaluate the cause of dyspnea. [18][19](Level of Evidence: C-LD) "


Class IIb
"7. In patients with HF and coronary artery disease (CAD) who are candidates for coronary revascularization, noninvasive stress imaging (stress echocardiography, single-photon emission CT [SPECT], CMR, or positron emission tomography [PET] may be considered for detection of myocardial ischemia to help guide coronary revascularization. [20][21][22][23][24] (Level of Evidence:B-NR) "


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References

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