Congestive heart failure exercise stress testing

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Initial and Serial Evaluation of the HF Patient
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Obstructive Sleep Apnea in the Patient with CHF
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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, cardiac catheterization can evaluate hemodynamic basis of heart failure and the response to drug, and 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.

ACC/AHA Guidelines- Exercise Stress Testing Recommendation [1][2]

Class IIa

1. Maximal exercise testing with or without measurement of respiratory gas exchange and/or blood oxygen saturation is reasonable in patients presenting with heart failure to help determine whether heart failure is the cause of exercise limitation when the contribution of heart failure is uncertain. (Level of Evidence: C)

2. Maximal exercise testing with measurement of respiratory gas exchange is reasonable to identify high-risk patients presenting with heart failure who are candidates for cardiac transplantation or other advanced treatments. (Level of Evidence: B)

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References

  1. 1.0 1.1 Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202
  2. 2.0 2.1 Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 119 (14):1977-2016. DOI:10.1161/CIRCULATIONAHA.109.192064 PMID: 19324967


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