Cardiopulmonary Exercise Testing and Cardiovascular Health describes new research and findings relevant to cardiovascular health as assessed by cardiopulmonary exercise testing. It brings together investigational cardiologists, pulmonologists and scientists who share a wealth of experience needed to judge the cardiovascular health, and the impairments of patients with a variety of illnesses. It presents the latest applications of cardiopulmonary exercise testing, including the use of computers and rapidly responding gas analysers, which make it possible to evaluate the cardiovascular system in a quantitative way.This book provides a comprehensive, updated presentation of the information that can be gained by cardiopulmonary exercise testing to assess the health of the cardiovascular system as a whole, and its individual components. It heralds a new era in which the instrumentation provides accurate measurements and the functions of the heart, pulmonary, and peripheral circulations and the lungs can be described quantitatively in graphical form. This enables the physician and investigator to measure the degree of success with which the cardiovascular system supports the O2 supply for the energy-generating mechanisms needed to sustain life.

Karlman Wasserman is the editor of Cardiopulmonary Exercise Testing and Cardiovascular Health, published by Wiley.

Contributors

iii

Preface

vii

Section 1 Physiological Basis of Cardiopulmonary Exercise Testing

Circulatory Coupling of External to Muscle Respiration During Exercise

3

(24)

Karlman Wasserman

William W. Stringer

Xing-Guo Sun

Akira Koike

Skeletal Muscle Metabolism During Exercise in Chronic Heart Failure

27

(16)

Koichi Okita

Section 2 Grading Heart Failure and Predicting Survival

Predicting Survival in Heart Failure: Exercise-Based Prognosticating Algorithms

43

(10)

Donna Mancini

Grading Heart Failure and Predicting Survival: Slope of VE versus VCO2

53

(10)

Andrew J.S. Coats

Peak VO2, Anaerobic Threshold, and Ventilatory Equivalent as Predictors of Survival in Heart Failure

63

(16)

Anselm K. Gitt

Caroline Bergmeier

Jochen Senges

Abnormalities in Exercise-Derived Gas Exchange Variables Other than Peak VO2 and Anaerobic Threshold in Chronic Heart Failure

79

(10)

Alain Cohen-Solal

Maria Tokmakova

Pierre Vladimir Ennezat

Jean-Yves Tabet

Time Constant for VO2 and Other Parameters of Cardiac Function in Heart Failure

89

(14)

Akira Koike

Michiaki Hiroe

Haruki Itoh

Optimizing Decision Making in Heart Failure: Applications of Cardiopulmonary Exercise Testing in Risk Stratification

103

(16)

Jonathan Myers

Preoperative Assessment of Elderly Surgical Patients

119

(18)

Paul Older

Adrian Hall

Section 3 Disease-Specific Abnormalities in Exercise Gas Exchange

Lung Diffusion Abnormalities and Exercise Capacity in Heart Failure

137

(14)

Pier Guiseppe Agostoni

Maurizio Bussotti

Cardiopulmonary and Metabolic Responses to Exercise in Patients with Hypertrophic Cardiomyopathy

151

(14)

Brian J. Whipp

Soraya Jones

Perry M. Elliott

Sanjay Sharma

William J. McKenna

Oxygen Uptake Abnormalities During Exercise in Coronary Artery Disease

165

(8)

Haruki Itoh

Akihiko Tajima

Akira Koike

Naohiko Osada

Tomoko Maeda

Makoto Kato

Kazuto Omiya

Long Tai Fu

Hiroshi Watanabe

Kazuzo Kato

Cardiopulmonary Exercise Testing in Pulmonary Vascular Disease: Arterial and End-Tidal CO2 Partial Pressures in Patients with Acute and Chronic Pulmonary Embolism and Primary Pulmonary Hypertension

173

(6)

Peer E. Waurick

Franz X. Kleber

Abnormalities in Exercise Gas Exchange in Primary Pulmonary Hypertension

179

(12)

Ronald J. Oudiz

Xing-Guo Sun

Exercise Gas Exchange in Peripheral Arterial Disease

191

(6)

Timothy A. Bauer

William R. Hiatt

Section 4 Sequential Changes in Exercise Gas Exchange to Assess Clinical Course and Therapy

Changing Assessment of Exercise Capacity in Potential Candidates for Cardiac Transplantation

197

(12)

Lynne Warner Stevenson

Exercise Training in Heart Failure Patients

209

(12)

Romualdo Belardinelli

Exercise Testing to Monitor Heart Failure Treatment

221

(18)

Marco Guazzi

Index

239

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