Congestive heart failure exercise stress testing

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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, and cardiac catheterization can evaluate the hemodynamic basis of heart failure and the response to drug. 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.

2009 ACC/AHA Focused Update and 2005 Guidelines for the Diagnosis and Management of Chronic Heart Failure in the Adult (DO NOT EDIT)

Exercise Stress Testing in Patients Presenting With Heart Failure (DO NOT EDIT)

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) "

"3. Maximal exercise testing with or without measurement of respiratory gas exchange is reasonable to facilitate prescription of an appropriate exercise program for patients presenting with HF. (Level of Evidence: C) "

Related Chapters

• Exercise stress testing

Vote on and Suggest Revisions to the Current Guidelines

• The CHF Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines

Sources

• The ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult

• 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

References

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