Heart failureReproducibility of Peak Oxygen Uptake and Other Cardiopulmonary Exercise Testing Parameters in Patients With Heart Failure (from the Heart Failure and A Controlled Trial Investigating Outcomes of exercise traiNing)
Section snippets
Methods
Enrollment criteria and study design for the HF-ACTION have been previously published.1 Subjects had a left ventricular ejection fraction ≤35% (caused by ischemic or nonischemic cardiomyopathy) and were on stable doses (i.e., the same dose for ≥6 weeks before enrollment) of optimal drug therapy, including an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker and a β blocker unless a contraindication was present. Of subjects enrolled in HF-ACTION, 94% were using an
Results
Table 1 lists baseline demographics and pVo2 for the 398 subjects in the study. On the first cardiopulmonary exercise test, mean pVo2 was 15.2 ± 5.0 ml/kg/min.
As listed in Table 2, mean exercise time increased significantly from test 1 to test 2. Conversely, mean pVo2 was virtually identical on the 2 tests. pVo2 was nearly as likely to increase from test 1 to test 2 (46% of subjects) as it was to decrease (48% of subjects). Moreover, pVo2 had substantial within-subject variability, averaging
Discussion
As a prespecified substudy of the HF-ACTION, we evaluated the reproducibility of pVo2 and other important cardiopulmonary exercise parameters in 398 subjects with HF who underwent 2 tests within 14 days of each other to assess the need for repeated baseline testing in all subjects. The major findings were (1) significant within-subject variability in pVo2 between the 2 tests (average coefficient of variation 6.6%), but the mean was the same between the 2 tests; (2) similar variability in other
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This work was supported by Grant No. 5U01HL063747 from the National Institutes of Health, Bethesda, Maryland.