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Universal Definition and Classification of Heart Failure: A Report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure Timing of Intervention in Aortic Stenosis A Fully Magnetically Levitated Circulatory Pump for Advanced Heart Failure Angiotensin–Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction Operator Experience and Outcomes After Left Main Percutaneous Coronary Intervention Meta-analysis of outcomes after intravascular ultrasound-guided versus angiography-guided drug-eluting stent implantation in 26,503 patients enrolled in three randomized trials and 14 observational studies Clinical applications of machine learning in the diagnosis, classification, and prediction of heart failure Dual Antiplatelet Therapy Duration: Reconciling the Inconsistencies Rationale and design of the GUIDE-IT study: Guiding Evidence Based Therapy Using Biomarker Intensified Treatment in Heart Failure Association Between Functional Impairment and Medication Burden in Adults with Heart Failure

Review Article2017 Sep 26;70(13):1618-1636.

JOURNAL:J Am Coll Cardiol. Article Link

Cardiopulmonary Exercise Testing: What Is its Value?

Guazzi M, Bandera F, Ozemek C et al. Keywords: exercise; gas exchange analysis; heart failure; oxygen consumption

ABSTRACT


Compared with traditional exercise tests, cardiopulmonary exercise testing (CPET) provides a thorough assessment of exercise integrative physiology involving the pulmonary, cardiovascular, muscular, and cellular oxidative systems. Due to the prognostic ability of key variables, CPET applications in cardiology have grown impressively to include all forms of exercise intolerance, with a predominant focus on heart failure with reduced or with preserved ejection fraction. As impaired cardiac output and peripheral oxygen diffusion are the main determinants of the abnormal functional response in cardiac patients, invasive CPET has gained new popularity, especially for diagnosing early heart failure with preserved ejection fraction and exercise-induced pulmonary hypertension. The most impactful advance has recently come from the introduction of CPET combined with echocardiography or CPET imaging, which provides basic information regarding cardiac and valve morphology and function. This review highlights modern CPET use as a single or combined test that allows the pathophysiological bases of exercise limitation to be translated, quite easily, into clinical practice.