{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"omics_type":["Unknown"],"volume":["7(6)"],"submitter":["Kinoshita M"],"pubmed_abstract":["<h4>Aims</h4>Traditional criteria for heart transplantation by cardiopulmonary exercise testing (CPX) include peak oxygen uptake (VO<sub>2</sub> ) < 14 mL/kg/min. Reaching a sufficient exercise load is challenging for patients with refractory heart failure (HF) because of their exercise intolerance. Recently, a substantial impact of right ventricular (RV) dysfunction was highlighted on urgent heart transplantation and mortality. This study aims to investigate the impact of RV contractile reserve, assessed by low-load exercise stress echocardiography (ESE), on exercise intolerance defined as peak VO<sub>2</sub>  < 14 mL/kg/min, in patients with HF.<h4>Methods and results</h4>We prospectively examined 67 consecutive patients hospitalized for HF who underwent ESE and CPX under a stabilized HF condition. Although low-load ESE was defined as 25 W load exercise, an increment in RV systolic (s') velocity was regarded as the preservation of RV contractile reserve. All patients completed low-load ESE. During low-load ESE, the variation in RV s' velocity significantly correlated with peak VO<sub>2</sub> (r = 0.787, P < 0.001). The change in RV s' velocity during low-load ESE accurately identified patients with peak VO<sub>2</sub>  < 14 mL/kg/min (area under the curve, 0.95; sensitivity, 92%; specificity, 85%). The intraclass correlation coefficient for intra-observer and inter-observer agreement for the change in RV s' velocity was 0.96 (95% confidence interval, 0.88-0.99, P < 0.001) and 0.86 (95% confidence interval, 0.64-0.95, P < 0.001), respectively. The RV-to-pulmonary circulation (PC) coupling, which was assessed by the slope of the relationship between RV s' velocity and pulmonary artery systolic pressure at rest and low-load exercise, was worse in the low-peak VO<sub>2</sub> group (<14 mL/kg/min) than the preserved-peak VO<sub>2</sub> group (≥14 mL/kg/min).<h4>Conclusions</h4>The change in RV s' velocity during low-load ESE could estimate the exercise capacity in HF patients. The assessments of RV contractile reserve and RV-to-PC coupling could be clinically beneficial to distinguish high-risk HF patients."],"journal":["ESC heart failure"],"pagination":["3810-3820"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC7755000"],"repository":["biostudies-literature"],"pubmed_title":["Impact of right ventricular contractile reserve during low-load exercise on exercise intolerance in heart failure."],"pmcid":["PMC7755000"],"pubmed_authors":["Nishimura K","Kinoshita M","Aono J","Higashi H","Ikeda S","Inoue K","Inaba S","Yamaguchi O","Nagai T","Sasaki Y","Akazawa Y","Uetani T","Fujii A"],"additional_accession":[]},"is_claimable":false,"name":"Impact of right ventricular contractile reserve during low-load exercise on exercise intolerance in heart failure.","description":"<h4>Aims</h4>Traditional criteria for heart transplantation by cardiopulmonary exercise testing (CPX) include peak oxygen uptake (VO<sub>2</sub> ) < 14 mL/kg/min. Reaching a sufficient exercise load is challenging for patients with refractory heart failure (HF) because of their exercise intolerance. Recently, a substantial impact of right ventricular (RV) dysfunction was highlighted on urgent heart transplantation and mortality. This study aims to investigate the impact of RV contractile reserve, assessed by low-load exercise stress echocardiography (ESE), on exercise intolerance defined as peak VO<sub>2</sub>  < 14 mL/kg/min, in patients with HF.<h4>Methods and results</h4>We prospectively examined 67 consecutive patients hospitalized for HF who underwent ESE and CPX under a stabilized HF condition. Although low-load ESE was defined as 25 W load exercise, an increment in RV systolic (s') velocity was regarded as the preservation of RV contractile reserve. All patients completed low-load ESE. During low-load ESE, the variation in RV s' velocity significantly correlated with peak VO<sub>2</sub> (r = 0.787, P < 0.001). The change in RV s' velocity during low-load ESE accurately identified patients with peak VO<sub>2</sub>  < 14 mL/kg/min (area under the curve, 0.95; sensitivity, 92%; specificity, 85%). The intraclass correlation coefficient for intra-observer and inter-observer agreement for the change in RV s' velocity was 0.96 (95% confidence interval, 0.88-0.99, P < 0.001) and 0.86 (95% confidence interval, 0.64-0.95, P < 0.001), respectively. The RV-to-pulmonary circulation (PC) coupling, which was assessed by the slope of the relationship between RV s' velocity and pulmonary artery systolic pressure at rest and low-load exercise, was worse in the low-peak VO<sub>2</sub> group (<14 mL/kg/min) than the preserved-peak VO<sub>2</sub> group (≥14 mL/kg/min).<h4>Conclusions</h4>The change in RV s' velocity during low-load ESE could estimate the exercise capacity in HF patients. The assessments of RV contractile reserve and RV-to-PC coupling could be clinically beneficial to distinguish high-risk HF patients.","dates":{"release":"2020-01-01T00:00:00Z","publication":"2020 Dec","modification":"2025-04-05T10:52:41.043Z","creation":"2025-04-05T10:52:41.043Z"},"accession":"S-EPMC7755000","cross_references":{"pubmed":["32924319"],"doi":["10.1002/ehf2.12968"]}}