© 2002 European Society of Cardiology
Central hemodynamic responses during serial exercise tests in heart failure patients using implantable hemodynamic monitors
a Southern Hospital Stockholm, Sweden
b St. Luke's Hospital Kansas, MO, USA
c Medtronic Inc Minneapolis, MN, USA
d Department of Cardiology, Karolinska Hospital S-171 76 Stockholm, Sweden
* Corresponding author. Tel.: +46-8-51773161; fax: +46-8-311044. E-mail address: lars.ryden{at}ks.se
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Abstract |
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Introduction: Exercise testing is commonly used in patients with congestive heart failure for diagnostic and prognostic purposes. Such testing may be even more valuable if invasive hemodynamics are acquired. However, this will make the test more complex and expensive and only provides information from isolated moments. We studied serial exercise tests in heart failure patients with implanted hemodynamic monitors allowing recording of central hemodynamics.
Methods: Twenty-one NYHA Class II–III heart failure patients underwent maximal exercise tests and submaximal bike or 6-min hall walk tests to quantify their hemodynamic responses and to study the feasibility of conducting exercise tests in patients with such devices.
Results: Patients were followed for 2–3 years with serial exercise tests. During maximal tests (n=70), heart rate increased by 52±19 bpm while SvO2 decreased by 35±10% saturation units. RV systolic and diastolic pressure increased 29±11 and 11±6 mmHg, respectively, while pulmonary artery diastolic pressure increased 21±8 mmHg. Submaximal bike (n=196) and hall walk tests (n=172) resulted in SvO2 changes of 80 and 91% of the maximal tests, while RV pressures ranged from 72 to 79% of maximal responses.
Conclusions: An added potential value of implantable hemodynamic monitors in heart failure patients may be to quantitatively determine the true hemodynamic profile during standard non-invasive clinical exercise tests and to compare that to hemodynamic effects of regular exercise during daily living. It would be of interest to study whether such information could improve the ability to predict changes in a patient's clinical condition and to improve tailoring patient management.
Key Words: Exercise testing • Hemodynamic monitoring • Heart failure
Received May 2, 2002; Revised July 15, 2002; Accepted September 25, 2002
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