Congestive heart failure exercise stress testing

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Surgical Therapy: Biventricular Pacing or Cardiac Resynchronization Therapy (CRT) Implantation of Intracardiac Defibrillator Ultrafiltration Cardiac Surgery Left Ventricular Assist Devices (LVADs) Cardiac Transplantation
ACC/AHA Guideline Recommendations Initial and Serial Evaluation of the HF Patient Hospitalized Patient Patients With a Prior MI Sudden Cardiac Death Prevention Surgical/Percutaneous/Transcather Interventional Treatments of HF Patients at high risk for developing heart failure (Stage A) Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B) Patients with current or prior symptoms of heart failure (Stage C) Patients with refractory end-stage heart failure (Stage D) Coordinating Care for Patients With Chronic HF Quality Metrics/Performance Measures
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Congestive heart failure end-of-life considerations
Specific Groups: Special Populations Patients who have concomitant disorders Obstructive Sleep Apnea in the Patient with CHF NSTEMI with Heart Failure and Cardiogenic Shock
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]

Overview

Exercise stress testing with an assessment of oxygen consumption is useful in assessing the functional capacity of the heart failure patient. Angiography can exclude the presence of an ischemic basis for the disease, and cardiac catheterization can evaluate the hemodynamic basis of heart failure and the response to drug. Myocardial viability studies can determine whether hypocontractile myocardium is viable but just hibernating, and could therefore benefit from revascularization.

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.

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) "

The above table adopted from 2021 ESC Guideline